The National Alliance of State and Territorial AIDS Directors (NASTAD) commends Secretary of Health and Human Services Kathleen Sebelius for today’s release of Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care & Treatment of Viral Hepatitis. NASTAD and other viral hepatitis advocates have called on HHS to develop such a plan for nearly a decade. The plan is a roadmap for what HHS agencies should be doing to address the prevention, care and treatment and research needs related to viral hepatitis.
“Having a coordinated national plan is an important step in responding to these epidemics, but state and local health departments and community based organizations need funding to provide basic services,” said NASTAD Executive Director Julie Scofield. Each state receives an annual average award of $90,000 to address adult viral hepatitis prevention. This barely supports one full time position in each jurisdiction and does not allow for any adult viral hepatitis prevention or care services. “The Administration and Congress must act with a greater sense of urgency around viral hepatitis and adequately fund state and local public health programs addressing viral hepatitis in the U.S.,” Scofield continued.
NASTAD is concerned that the Administration and Congress have not adequately prioritized viral hepatitis. The Centers for Disease Control and Prevention’s (CDC) Adult Viral Hepatitis Prevention Coordinator program, the public health professionals responsible for the implementation of this plan across the nation, needs adequate funding to respond to the viral hepatitis epidemics. This Action Plan will be difficult to implement unless investments are made to actively integrate hepatitis services into the existing public health infrastructure. This should begin with funding to implement direct services such as hepatitis B and C testing, hepatitis A and B vaccination of adults, education and a national chronic hepatitis surveillance system.
State and local health departments are important implementing partners of this plan, and their expertise should be sought throughout the implementation process. “Just as the HIV/AIDS community has been a valued partner in the implementation of the National HIV/AIDS Strategy, the viral hepatitis community should be included in the implementation of this Action Plan,” commented Scofield. In addition, the federal government cannot successfully implement this Action Plan if health departments are not funded to the fullest extent in every state, regardless of disease burden. It is estimated that over five million people are infected with viral hepatitis in the U.S. and 65-75 percent are unaware of their infection. The costs of inaction are too high not to be a priority, especially given this new federal roadmap and the tools to effectively prevent and manage viral hepatitis (hepatitis B vaccine and effective hepatitis B treatments that reduce disease progression and new treatments that increase hepatitis C cure rates up to 75 percent).
Toward that end, NASTAD calls on HHS and CDC leadership to strengthen the Adult Viral Hepatitis Prevention Coordinator program in all jurisdictions and to allocate increased resources to prevention services. These include testing to identify the 65-75 percent who are living unaware of their infection, education to increase public and provider awareness, and surveillance to increase knowledge of disease burden and to improve targeted interventions.
NASTAD applauds the Administration and Congress for increasing the budget of the Division of Viral Hepatitis (DVH) in recent years and calls on Congress to provide at least an increase to the President’s FY2012 request of $5.2 million for DVH. DVH, however, has developed an estimated need of approximately $300 million to expand testing, education and chronic surveillance. In addition to funding for DVH, NASTAD requests that the HHS Office of the Assistant Secretary for Health be provided resources to implement the Action Plan and that CDC identify funding to continue the At-Risk Adult Hepatitis B Vaccine Initiative.
