An estimated 12,000 – 14,000 people are currently living with hepatitis C in Wales, around half undiagnosed.
It is one of the three main causes of liver disease and the only one of the five ‘big killers’ in Wales and England where deaths are rising.
It therefore represents a significant public health challenge.
As I said in January’s Debate on the contamination of blood, “in the 1970s and 1980s, a large proportion of blood products supplied to patients by the NHS was contaminated with HIV or hepatitis C. Around 4,670 patients with haemophilia were infected; over 2,000 have since died in the UK, with 70 in Wales, from the effects of these viruses”.
However, evidentially Hepatitis C primarily affects people from particular groups, such as injecting drug users, homeless people, gay and bisexual men, and migrant populations from high prevalence regions.
The recent Hepatitis C Trust report, “Hepatitis C in Wales: Perspectives, challenges & solutions”, concludes with a number of key recommendations for action, as follows:
- The inclusion of a commitment to eliminate hepatitis C as a serious public health concern within the Welsh Government’s forthcoming Public Health Bill.
- The implementation of a public awareness campaign aimed at tackling stigma around hepatitis C and encouraging individuals to access testing.
- A continuation of, and long-term commitment to, the successful all-Wales hepatitis C treatment protocol, which ensures equal access to new, highly effective treatments for increased numbers of people.
- An increase in the number of community-based treatment services, to ensure access to treatment for groups who traditionally find services difficult to access.
- Full implementation of an opt-out approach to Blood Borne Viruse – BBV -testing in substance misuse services, as set out in the Welsh Government’s Working Together to Reduce Harm: Substance Misuse Delivery Plan 2016 – 2018.
- And using opportunities, such as mandatory GP education days, to deliver BBV training to key primary care professionals
Approval of new drug treatments by NICE and the All-Wales Medicines Strategy Group means the elimination of hepatitis C as a serious public health concern in Wales is now a wholly achievable goal.
To seize this new opportunity, we must find the 50% of people currently undiagnosed, by widening access to testing and further investigating which groups can be cost-effectively screened.
By increasing diagnoses, we will be able to treat and cure more people.
With effective and accessible new treatments now available, to all who need them, it is easier than ever to treat and cure patients, presenting a great opportunity to achieve the elimination of hepatitis C in Wales.
The key steps that the Hepatitis Trust believes will help to drive progress in this are:
- Increasing testing in primary care, antenatal care and pharmacies in order to find the undiagnosed.
- Implementing a strategy to re-engage patients who have tested positive for hepatitis C but disengaged from the care pathway.
- Launching a public awareness campaign to find undiagnosed patients, particularly those who may have contracted the virus a long time ago and are unaware they were ever at risk.
- Making treatment available to hepatitis C patients in community settings, such as drug services and GP surgeries, to widen access to patients traditionally considered ‘hard-to-reach’.
- Providing training and information about hepatitis C to healthcare professionals, particularly GPs.
- Making the use of ‘buddy’ schemes more widespread AND ensuring the provision of peer education in substance misuse services, in order to tackle barriers to patients engaging in treatment and spread key messages to at-risk groups.
Backing calls for a Hepatitis C eliminations strategy, global research- based biopharmaceutical company, AbbVie, has called for this to “set out the steps to elimination including annual testing, screening, diagnosis and treatment numbers.
“The strategy should have Ministerial oversight and be driven by the hepatitis C sub-group of the Welsh Liver Plan Implementation Board, with a mandate to ensure ambitious targets are met across all local health boards.
And the Welsh Government and NHS should continue its open approach to engagement with all partners involved in delivering care and treatment to people living with Hepatitis C, so that flexible and innovative care models can be established, such as peer to peer support in community settings.
As they say “Changing models of care will require a renewed approach to education, training and workforce development”.
As today’s motion therefore states, we call on the Welsh Government to confirm their commitment to the World Health Organisation Eradication Date of 2030 – and to consider new operational guidelines to support NHS Wales to work towards this.