On January 7, 2021, the U.S. Department of Health and Human Services (HHS) released Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination (2021—2025) (“the Hepatitis Plan”), which provides a framework for the elimination of viral hepatitis in the United States. The Hepatitis Plan builds on three previous national plans but reflects the changing landscape of hepatitis prevention and control. Notably, it is the first to aim for the elimination of viral hepatitis and recognizes the importance of addressing inequities and ensuring a coordinated approach to the syndemic of viral hepatitis, HIV, STIs, and substance use.
We have the tools to eliminate viral hepatitis in the United States, but hepatitis A (HAV) and hepatitis C (HCV) cases are on the rise and progress against hepatitis B (HBV) has stalled. These trends are the result of several factors, including the increase in injection drug use which has driven the spread of HBV and HCV; stigma, discrimination, and social and structural barriers that impede access to hepatitis services; and chronic underfunding of the public health response to hepatitis. The Hepatitis Plan recognizes and responds to these challenges, and includes goals, objectives, and indicators related to addressing inequities and ensuring a collaborative approach to the syndemic of viral hepatitis, HIV, STIs, and substance use.
Local health departments (LHDs) are leaders in the prevention and control of viral hepatitis and will be critical in ensuring the implementation and success of the plan. A recent NACCHO study revealed that most LHDs conduct viral hepatitis surveillance and case investigation, respond to HAV outbreaks, and provide hepatitis prevention, testing, linkage to care, and treatment services. LHDs also play an important role in addressing gaps and inequities in access to hepatitis services by conducting outreach and education to local healthcare providers and their communities and integrating hepatitis services into harm reduction services, STI clinics, correctional facilities, and other priority settings.
The Hepatitis Plan lays out a clear pathway for the elimination of viral hepatitis in the United States and recognizes the need for a coordinated, whole-of-nation approach that targets gaps and inequities in access to hepatitis services. LHDs have a leading role to play in its implementation but will need significant resources and support to scale up hepatitis services in the wake of the COVID-19 pandemic. For additional information about the role of NACCHO and LHDs in the prevention and elimination of viral hepatitis, visit here.