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Abstract Details
A global investment framework for the elimination of hepatitis B
J Hepatol. 2020 Sep 21;S0168-8278(20)33625-4. doi: 10.1016/j.jhep.2020.09.013.Online ahead of print.
Jessica Howell1, Alisa Pedrana2, Sophia E Schroeder2, Nick Scott2, Lisa Aufegger3, Rifat Atun4, Ricardo Baptista-Leite5, Gottfried Hirnschal6, Ellen 't Hoen7, Sharon J Hutchinson8, Jeffrey V Lazarus9, Lesi Olufunmilayo10, Raquel Peck11, Manik Sharma12, Annette H Sohn13, Alexander Thompson14, Mark Thursz15, David Wilson2, Margaret Hellard16
Author information
1Disease Elimination Programme, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia. Electronic address: jess.howell@burnet.edu.au.
2Disease Elimination Programme, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
3Centre for Health Policy, Imperial College London.
4Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
5Universidade Catolica Portuguesa, Lisbon, Portugal; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
6Department of HIV and Global Hepatitis Programme, World Health Organization.
7Global Health Unit, University Medical Centre, Groningen, the Netherlands; Medicines Law & Policy, Amsterdam, The Netherlands.
8School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK; Health Protection Scotland, Meridian Court, Cadogan St, Glasgow, UK.
9Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.
10Department of Medicine, Medicine, College of Medicine, University of Lagos, Nigeria.
11World Hepatitis Alliance, London, UK.
12Division of Gastroenterology and Hepatology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
13TREAT Asia/amfAR, Foundation for AIDS Research, Bangkok, Thailand.
14Department of Medicine, University of Melbourne, Melbourne, Australia; Department of Gastroenterology, St Vincent's Hospital Melbourne, Australia.
15Department of Hepatology, Imperial College London, London, UK.
16Disease Elimination Programme, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Department of Infectious Diseases, The Alfred and Monash University, Australia.
Abstract
Background and aims: More than 292 million people are living with hepatitis B worldwide and are at risk of death from liver cirrhosis and liver cancer. The World Health Organization (WHO) has set global targets for the elimination of viral hepatitis as a public health threat by 2030. However, current levels of global investment in viral hepatitis elimination programmes are insufficient to achieve these goals.
Methods: To catalyse political commitment and to encourage domestic- and international-financing, we used published modelling data and key stakeholder interviews to develop an investment framework to demonstrate the return on investment for viral hepatitis elimination.
Results: The framework utilizes a public health approach to identify evidence-based national activities that reduce viral hepatitis-related morbidity and mortality, as well as international activities and critical enablers that allow countries to achieve maximum impact on health outcomes from investment to achieve WHO 2030 elimination targets.
Conclusion: Focusing on hepatitis B, this health policy paper employs the investment framework to estimate the substantial economic benefits of investing in the elimination of hepatitis B and demonstrates how such investments could be cost-saving by 2030.