Seminars in Liver Disease
Volume 38, Issue 3, 2018, Pages 181-192

The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations (Review) (Open Access)

Lazarus J.V.* , Safreed-Harmon K. , Thursz M.R. , Dillon J.F. , El-Sayed M.H. , Elsharkawy A.M. , Hatzakis A. , Jadoul M. , Prestileo T. , Razavi H. , Rockstroh J.K. , Wiktor S.Z. , Colombo M.
  • a Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle Roselló 132, Barcelona, ES-08036, Spain
  • b Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle Roselló 132, Barcelona, ES-08036, Spain
  • c Department of Surgery and Cancer, Imperial College, London, United Kingdom
  • d Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
  • e Department of Pediatrics, Ain Shams University, Cairo, Egypt
  • f University Hospitals Birmingham, Mindelsohn Way, Birmingham, United Kingdom
  • g Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
  • h Department of Nephrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
  • i Infection Diseases Unit, Centre for Migration and Health, ARNAS, Civico-Benfratelli Hospital, Palermo, Italy
  • j Center for Disease Analysis Foundation, Lafayette, CO, United States
  • k Department of Medicine i, University of Bonn, Bonn, Germany
  • l Department of Global Health, University of Washington, Schools of Medicine and Public Health, Seattle, WA, United States
  • m Department of Medicine, Clinical and Research Center, Humanitas Hospital, Rozzano, Italy

Abstract

The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV, and it can build momentum by producing small victories that inspire more ambitious efforts. The micro-elimination approach encourages stakeholders who are most knowledgeable about specific populations to engage with each other and also promotes the uptake of new models of care. Examples of micro-elimination target populations include medical patients, people who inject drugs, migrants, and prisoners, although candidate populations can be expected to vary greatly in different countries and subnational areas. © 2018 by Thieme Medical Publishers, Inc.

Author Keywords

Health systems models of care micro-elimination health policy Hepatitis C

Index Keywords

Vulnerable Populations vulnerable population hematologic disease hemophilia cooperation management transmission Human immunodeficiency virus infection Models, Organizational health care policy indigenous people nonbiological model stakeholder engagement human Antiviral Agents Stakeholder Participation hemodialysis patient prisoner priority journal international cooperation disease eradication ethnology people who inject drug Humans migrant risk factor Risk Factors Review high risk population prevalence organization and management legislation and jurisprudence graft recipient disease elimination global health Health Policy antivirus agent Delivery of Health Care, Integrated integrated health care system Cooperative Behavior interdisciplinary communication policy making mixed infection hepatitis C
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049846307&doi=10.1055%2fs-0038-1666841&partnerID=40&md5=5361ddba89fde2dda69e42ed209038f8
DOI: 10.1055/s-0038-1666841
ISSN: 02728087
Cited by: 15
Original Language: English