The Silent Pandemic: Tackling Hepatitis C with Policy Innovation was developed by the Economist Intelligence Unit and investigates the challenges posed by the hepatitis C virus and how systemic policy innovation can minimise its impact. The report found:
A need for better surveillance and epidemiology. As one official interviewed for this study noted, “we don’t have a real understanding of the magnitude” of the challenge HCV presents. Too few countries – developed or developing – have recently conducted the epidemiological studies necessary for good policymaking at a national, let alone a local level. According to the World Hepatitis Alliance, a patient group, within the European Union only the Netherlands has good data on hepatitis B and C, while in 16 EU countries the data are either poor or non-existent.
Significant barriers to addressing the disease exist, including a lack of scientific knowledge, poor public awareness and delay of treatment owing to cost and side effects. Despite substantial scientific progress since the discovery of HCV in 1989 and the availability of increasingly effective treatments with improving cure rates, some basic elements of its biology remain a mystery, such as why some people develop end-stage conditions and others do not. At the same time, the public remains largely ill-informed about HCV: a survey by the European Liver Patients Association found that only 20% of those diagnosed had heard of hepatitis B or C before being told they had it.
For too many developing countries, the healthcare system itself remains a leading vector of transmission for hepatitis C. In 2008 the WHO found that for those low-income countries where data are available, only 53% of blood was screened for the virus in a quality-assured manner, and that in 39 countries donated blood was not routinely screened at all.
The high incidence and prevalence of HCV among injecting drug users in developed countries presents prevention and treatment problems and has stigmatised the disease and presents a series of related problems in addressing HCV.
Facing up to the challenges posed by HCV requires a co-ordinated strategy covering a range of areas. HCV will not go away on its own. Countries which have had the most success so far have tended to focus on the problem in a co-ordinated way, rather than on one individual aspect. Each country will have different needs and resources, but all should consider obtaining strong data, raising awareness of the disease and focusing on prevention.
The launch of the report included presentations from Paul Kielstra from the Economist Intelligence Unit; Charles Gore, President of the World Hepatitis Alliance; Jack Wallace, Executive Member of the Coalition for the Eradication of Viral Hepatitis in Asia and the Pacific (CEVHAP) and Prof. David Goldberg, Head of Scottish Hepatitis C Programme. The report was supported by Janssen Pharmaceutica NV and its findings are based on extensive desk research and interviews conducted with leading global medical and policy experts.