Hepatitis C Action Plan for Scotland Phase 1: September 2006 – August 2008
In 2004, Scotland’s Minister for Health and Community Care stated that “Hepatitis C is one of the most serious and significant public health risks of our generation”. By December 2005, Health Protection Scotland (HPS) estimated that 50,000 persons in Scotland had been infected with the Hepatitis C virus and that 37,500 were chronic carriers.
Around 90% of those infected acquired their virus through injecting drug use behaviour (sharing needles/ syringes and other injecting paraphernalia) and the majority of these were former injectors who remained undiagnosed. It was estimated that only 20% of the 37,500 chronically infected individuals had ever been in specialist care and only 4% had received a course of Interferon and Ribavirin - therapy which i) has been deemed cost effective by National Institute of Clinical Excellence (NICE) and Quality Improvement Scotland (QIS), ii) effects sustained viral clearance in 50-60% of instances and iii) is likely to have a major impact in reducing the rate of Hepatitis C disease progression (naturally, 5-15% of carriers develop cirrhosis within 4 20 years). As at December 2005, HPS estimated that around 2,000 Hepatitis C infected persons had developed cirrhosis and that 1,000-1,500 were becoming infected annually.
Following an extensive consultation in 2005, the Health Minister and Chief Medical Officer launched Scotland’s Action Plan for Hepatitis C in September 2006 http:// www.scotland.gov.uk/Publications/2006/09/15093626/0. Its aims are:
- To prevent the spread of Hepatitis C particularly among Injecting Drug Users (IDUs).
- To diagnose Hepatitis C infected persons, particularly those who would most benefit from treatment.
- To ensure that those infected receive optimal treatment, care and support.
The Plan is a two-phased one: 41 actions spread across the areas of co-ordination, prevention, testing/treatment/care/support and education/ training/awareness-raising (Appendix 1). To support Introduction 5 the implementation of local actions, the Scottish Government Public Health and Wellbeing Directorate (SGPHWD), formerly the Scottish Executive Health Department (SEHD), has made available to NHS Boards an additional £4 million for the period 2006-2008. One of the key actions is to prepare costed proposals for the development of services in each of the three areas, as above, to be undertaken in Phase II. These proposals will be considered by SGPHWD in early 2008.
This report provides an annual update on progress made on the implementation of the Action Plan (Phase I). It is divided into four main sections:
- Co-ordination of the Action Plan and Preparations for Phase II:
- Actions on Prevention
- Actions on Testing, Treatment, Care and Support
- Actions on Education, Training and Awareness raising.