The National Academies of Sciences, Engineering and Medicine Reports on Viral Hepatitis

A National Strategy for the Elimination of Hepatitis B and C

In the face of recent developments in hepatitis C treatment, enhanced global solidarity for hepatitis B and hepatitis C elimination goals, and progress implementing The National Viral Hepatitis Action Plan (2017-2020) [PDF – 84 pages], an ambitious strategy to set and achieve HBV and HCV elimination goals in the United States is needed. In 2015, the Division of Viral Hepatitis (DVH) within the U.S. Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) commissioned the National Academy of Medicine of the National Academies of Sciences, Engineering and Medicine to convene an expert committee to examine scientific and policy issues related to the prevention, detection, control, and management of hepatitis B and hepatitis C. DVH and its co-sponsors tasked the National Academies to determine whether elimination goal(s) are feasible for hepatitis C incidence, hepatitis C mortality, hepatitis B incidence, and hepatitis B mortality; and, if so, what the goals and plan of action to achieve the elimination goals should specify. The National Academies’ efforts to develop this strategy were accomplished in the following two phases:

• Phase 1: Eliminating the Public Health Problem of Hepatitis B and C in the United States (2016)
  In partnership with the Office of Minority Health (OMH) in the Office of the Secretary (OS) of HHS, DVH commissioned The National Academies to determine whether elimination goals for hepatitis B and hepatitis C in the United States are feasible and to identify possible critical success factors. The Phase I report explores the barriers that must be overcome to eliminate hepatitis B and hepatitis C in the United States – and reaffirms that hepatitis elimination can be achieved with the right resources, commitment, and strategy.
  www.nas.edu/HepatitisElimination

• Phase 2: A National Strategy for the Elimination of Hepatitis B and C (2017)
  In Phase 2, DVH and its co-sponsors: the National Viral Hepatitis Roundtable (NVHR), OMH, the Division of Cancer Prevention and Control (DCPC) within CDC, the American Association for the Study of Liver Disease (AASLD), and the Infectious Diseases Society of America (IDSA), commissioned the National Academies to develop a consensus report that includes specific recommendations and targets for elimination. The report identifies:
  1. the appropriate hepatitis reduction or elimination goal(s) and specifies a plan of action to achieve the goal(s) including: medical and substance abuse services, community-based services, and correctional health services;
  2. barriers to achieving the goal(s) such as access to treatment and related policy issues, public health infrastructure resources for screening, education and outreach, and surveillance;
  3. potential solutions to the barriers identified; and
  4. specific stakeholders and their responsibilities to achieve the goal.

  www.nas.edu/HepatitisElimination

Information about CDC’s perspective on the Phase 2 report is available in a joint letter from the DVH and NCHHSTP Directors to partners [PDF – 275 KB].

Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C (2010)

CDC, along with other partners, commissioned the Institute of Medicine (IOM) to examine the prevention and control of viral hepatitis infections in the United States. The IOM issued three report briefs – Report Brief for State and Local Health Departments, Report Brief for Health Care Providers and Report Brief about Harm Reduction, all available in the “Report at a Glance” section.

The committee identified the underlying factors that impede current efforts to prevent and control these diseases. Three major factors were found:

• There is a lack of knowledge and awareness about chronic viral hepatitis on the part of the health-care and social-service providers
• There is a lack of knowledge and awareness about chronic viral hepatitis among at-risk populations, members of the public and policy-makers
• There is insufficient understanding about the extent and seriousness of the public health problem, so inadequate public resources are being allocated to prevention, control and surveillance programs

Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C [PDF – 253 pages]