Journal Article > ReviewFull Text
Lancet Gastroenterol Hepatol. 1 February 2019; Volume 4 (Issue 2); 135-184.; DOI:10.1016/S2468-1253(18)30270-X
Cooke GS, Andrieux-Meyer I, Applegate TL, Atun R, Burry J, et al.
Lancet Gastroenterol Hepatol. 1 February 2019; Volume 4 (Issue 2); 135-184.; DOI:10.1016/S2468-1253(18)30270-X
Viral hepatitis is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. Highly effective prevention measures and treatments have made the global elimination of viral hepatitis a realistic goal, endorsed by all WHO member states. Ambitious targets call for a global reduction in hepatitis-related mortality of 65% and a 90% reduction in new infections by 2030. This Commission draws together a wide range of expertise to appraise the current global situation and to identify priorities globally, regionally, and nationally needed to accelerate progress. We identify 20 heavily burdened countries that account for over 75% of the global burden of viral hepatitis. Key recommendations include a greater focus on national progress towards elimination with support given, if necessary, through innovative financing measures to ensure elimination programmes are fully funded by 2020. In addition to further measures to improve access to vaccination and treatment, greater attention needs to be paid to access to affordable, high-quality diagnostics if testing is to reach the levels needed to achieve elimination goals. Simplified, decentralised models of care removing requirements for specialised prescribing will be required to reach those in need, together with sustained efforts to tackle stigma and discrimination. We identify key examples of the progress that has already been made in many countries throughout the world, demonstrating that sustained and coordinated efforts can be successful in achieving the WHO elimination goals.
Journal Article > CommentaryFull Text
BMJ Glob Health. 1 April 2022; Volume 7 (Issue 4); e009010.; DOI:10.1136/bmjgh-2022-009010
Lazarus JV, Abdool Karim SS, van Selm L, Doran J, Batista C, et al.
BMJ Glob Health. 1 April 2022; Volume 7 (Issue 4); e009010.; DOI:10.1136/bmjgh-2022-009010
SUMMARY BOX
-- There has been open and closed vial COVID-19 vaccine wastage in low-income, middle-income and high-income countries, with wastage rates of up to 30%.
-- Plans to monitor, forecast and ultimately reduce vaccine wastage are urgently needed in every country.
-- Open vial wastage should be reduced by strategies increasing overall vaccination rates, such as overbooking appointments and appointment-free vaccination, as well as through technologies maximising the number of doses being extracted from the vial.
-- Closed vial wastage should be reduced by timely, well-organised surplus donations and reallocations, as well as supporting effective supply chain management in recipient countries.
-- There has been open and closed vial COVID-19 vaccine wastage in low-income, middle-income and high-income countries, with wastage rates of up to 30%.
-- Plans to monitor, forecast and ultimately reduce vaccine wastage are urgently needed in every country.
-- Open vial wastage should be reduced by strategies increasing overall vaccination rates, such as overbooking appointments and appointment-free vaccination, as well as through technologies maximising the number of doses being extracted from the vial.
-- Closed vial wastage should be reduced by timely, well-organised surplus donations and reallocations, as well as supporting effective supply chain management in recipient countries.
Journal Article > Short ReportAbstract
Int J Drug Policy. 3 July 2017; Volume 47; DOI:10.1016/j.drugpo.2017.05.019
Grebely J, Bruneau J, Lazarus JV, Dalgard O, Bruggmann P, et al.
Int J Drug Policy. 3 July 2017; Volume 47; DOI:10.1016/j.drugpo.2017.05.019
Globally, it is estimated that 71.1 million people have chronic hepatitis C virus (HCV) infection, including an estimated 7.5 million people who have recently injected drugs (PWID). There is an additional large, but unquantified, burden among those PWID who have ceased injecting. The incidence of HCV infection among current PWID also remains high in many settings. Morbidity and mortality due to liver disease among PWID with HCV infection continues to increase, despite the advent of well-tolerated, simple interferon-free direct-acting antiviral (DAA) HCV regimens with cure rates >95%. As a result of this important clinical breakthrough, there is potential to reverse the rising burden of advanced liver disease with increased treatment and strive for HCV elimination among PWID. Unfortunately, there are many gaps in knowledge that represent barriers to effective prevention and management of HCV among PWID. The Kirby Institute, UNSW Sydney and the International Network on Hepatitis in Substance Users (INHSU) established an expert round table panel to assess current research gaps and establish future research priorities for the prevention and management of HCV among PWID. This round table consisted of a one-day workshop held on 6 September, 2016, in Oslo, Norway, prior to the International Symposium on Hepatitis in Substance Users (INHSU 2016). International experts in drug and alcohol, infectious diseases, and hepatology were brought together to discuss the available scientific evidence, gaps in research, and develop research priorities. Topics for discussion included the epidemiology of injecting drug use, HCV, and HIV among PWID, HCV prevention, HCV testing, linkage to HCV care and treatment, DAA treatment for HCV infection, and reinfection following successful treatment. This paper highlights the outcomes of the roundtable discussion focused on future research priorities for enhancing HCV prevention, testing, linkage to care and DAA treatment for PWID as we strive for global elimination of HCV infection.