Australia’s new five year strategy for hepatitis C will build on the achievements obtained with direct-acting antiviral cures but with more emphasis on preventive interventions.

The Fifth National Hepatitis C Strategy (2018-2022) released on 29 November notes that more than 43,000 of the 227,000 people with chronic HCV began treatment with PBS-listed antiviral cures throughout the 2014-2017 strategy. However it fell short of its goal of a 50% reduction in incidence of the infection, due to significant levels of ongoing transmission through shared needles and syringes.

The new strategy therefore has a strong focus on promoting proven preventive measures such as Needle and Syringe Programs (NSPs) and Opioid Treatment Programs (OTPs), particularly in the high risk populations such as prisons.

The new strategy also notes that almost 20% of people with HCV – around 38,000 – remain undiagnosed, and therefore more effort is needed to improve screening and follow up of people with HCV, such as with rapid testing and point of care technologies.

Other key areas for action include:

• Improving awareness of HCV and its prevention, detection and treatment options in priority populations;
• Development of peer-based support models;
• Addressing stigma and discrimination around HCV to increase access to services;
• Developing innovative workforce models to promote HCV detection and management in the community rather than in specialist settings;
• Improve access to specialist care for people living with hepatitis C who have more complex needs, such as those with cirrhosis.

The main goals of the new strategy are to make significant progress towards eliminating HCV as a public health threat; reduce mortality and morbidity related to HCV; eliminate the negative impact of stigma, discrimination, and legal and human rights issues on people’s health and minimise the personal and social impact of hepatitis C.

The targets to be achieved by the end of 2022 are:

• Reduce the number of newly acquired hepatitis C infections, with a focus on priority populations by 60%;
• Increase the proportion of people living with hepatitis C who are diagnosed to 90%;
• Increase the cumulative proportion of people living with chronic hepatitis C who have initiated direct-acting antiviral treatment to 65%;
• Reduce hepatitis C attributable mortality overall by 65%;
• Reduce by 50% the reported experience of stigma among people living with hepatitis C, and the expression of stigma, in respect to hepatitis C status.

The HCV strategy is one of five new strategies covering HIV and Blood Borne Viruses, including the Third National Hepatitis B Strategy.