National Hepatitis Elimination Profiles Released for Two of the World's Most Advanced HCV Elimination Programs: Egypt and Rwanda
On February 25,the National Hepatitis Elimination Profiles for Egypt and Rwanda were released. Egypt and Rwanda are home to two of the most advanced hepatitis C elimination programs in the world. Their success in scaling-up hepatitis C testing and treatment is a result of many factors, including high-level government commitment, setting ambitious goals, expanding and decentralizing testing, and simplifying treatment algorithms. Both countries demonstrate the possibility of HCV elimination, even in low-resource settings.
Key Takeaways from Rwanda National Hepatitis Elimination Profile
- The prevalence of HCV is estimated to have declined by approximately 70% from 2018 and 2020 due to the national HCV elimination program with a goal of achieving HCV elimination by 2024
- Over 6 million persons have been screened for HCV since 2015 and over 50,000 persons received treatment
- For HBV, an estimated 85% of persons living with HBV have been diagnosed
- Rwanda leveraged the HIV infrastructure to expand HBV and HCV testing and treatment
- Total acquisition cost of commodities for HCV rapid diagnostic test, viral load test,
treatment, and SVR12 test is under US$80 (US$60 for treatment only) per patient.
Patients don’t pay for HBV and/or HCV diagnostic and treatment services.
- Point-of-care viral load testing is not yet available but the program plans to expand viral load testing access from 15 sites to all hospitals and health centers
- Funding remains constrained
- The program looks forward to monitoring progress towards 2024 elimination goals with a national verification process and piloting of WHO elimination tools
Key Takeaways from Egypt National Hepatitis Elimination Profile:
- The National Committee for Control of Viral Hepatitis (NCCVH) set a national strategy in 2014 to make treatment paid for by the Egyptian government available for all, aiming to achieve elimination by 2020
- New HCV infections are estimated to have declined by 41% from 2015 to 2020 and deaths by 51% from 2015-2019 due to the national HCV program
- The Egyptian Presidential Initiative, 100 Million Healthy Lives, was launched in October 2018 with the goal of screening the entire adult population for HCV. This program is the largest HCV screening program in the world. Under the 100 Million Healthy Lives, over 240,000 people were screened per day. There were 77 PCR testing sites around the country with capacity for 36,000 PCR tests daily. From October 2018 to April 2019, over 60 million persons were screened for HCV.
- Over 4 million persons were treated for HCV from 2014-2020. Across the country over 150 specialized centers for treatment of viral hepatitis were established within government healthcare facilities. Mobile vans were used to reach rural patients.
- More progress is needed in improving access to HBV testing and treatment. Only 10-15% of persons living with HBV are estimated to have been diagnosed
- Harm reduction programs for persons who inject drugs must be strengthened
- Egypt looks forward to validating HCV elimination through internal and external WHO processes and sharing lessons learned with other countries
Background on National Hepatitis Elimination Profiles
On World Hepatitis Day, the Coalition for Global Hepatitis Elimination and local partners launch a new initiative to develop National Hepatitis Elimination Profiles for 35+ countries. The profiles report progress toward hepatitis elimination in the countries, and reveal strengths and limitations in national plans, policies and programs necessary for equitable access to hepatitis prevention, testing, and treatment. With this information in hand, the Coalition and local partners to advocate for the feasible next steps to keep countries on track to eliminate hepatitis. Profiles to date have been released for Argentina, Brazil, Canada, Egypt, Ghana, Mexico, Rwanda, Peru, Portugal, and the United States.