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1. The case for simplifying and using absolute targets for viral hepatitis elimination goals

Author

Razavi, H. Blach, S. Razavi-Shearer, D. Abaalkhail, F. Abbas, Z. Abdallah, A. Abrao Ferreira, P. Abu Raddad, L.J. Adda, D. Agarwal, K. Aghemo, A. Ahmed, A. Al-Busafi, S.A. Al-hamoudi, W. Al-Kaabi, S. Al-Romaihi, H. Aljarallah, B. AlNaamani, K. Alqahtani, S. Alswat, K. Altraif, I. Asselah, T. Bacon, B. Bessone, F. Bizri, A.R. Block, T. Bonino, F. Brandão-Mello, C.E. Brown, K. Bruggmann, P. Brunetto, M.R. Buti, M. Cabezas, J. Calleja, J.L. Castro Batänjer, E. Chan, H.L.-Y. Chang, H. Chen, C.-J. Christensen, P.B. Chuang, W.-L. Cisneros, L. Cohen, C. Colombo, M. Conway, B. Cooper, C. Craxi, A. Crespo, J. Croes, E. Cryer, D. Cupertino de Barros, F.P. Derbala, M. Dillon, J. Doss, W. Dou, X. Doyle, J. Duberg, A.-S. Dugan, E. Dunn, R. Dusheiko, G. El Khayat, H. El-Sayed, M.H. Eshraghian, A. Esmat, G. Esteban Mur, R. Ezzat, S. Falconer, K. Fassio, E. Ferrinho, P. Flamm, S. Flisiak, R. Foster, G. Fung, J. García-Samaniego, J. Gish, R.G. Gonçales, F. Halota, W. Hamoudi, W. Hassany, M. Hatzakis, A. Hay, S. Himatt, S. Hoepelman, I.M. Hsu, Y.-C. Hui, Y.T. Hunyady, B. Jacobson, I. Janjua, N. Janssen, H. Jarcuska, P. Kabagambe, K. Kanto, T. Kao, J.-H. Kaymakoglu, S. Kershenobich, D. Khamis, F. Kim, D.J. Kim, D.Y. Kondili, L.A. Kottilil, S. Kramvis, A. Kugelmas, M. Kurosaki, M. Lacombe, K. Lagging, M. Lao, W.-C. Lavanchy, D. Lazarus, J.V. Lee, A. Lee, S.S. Levy, M. Liakina, V. Lim, Y.-S. Liu, S. Maddrey, W. Malekzadeh, R. Marinho, R.T. Mathur, P. Maticic, M. Mendes Correa, M.C. Mera, J. Merat, S. Mogawer, S. Mohamed, R. Muellhaupt, B. Muljono, D. Mostafa, I. Nahum, M.S. Nawaz, A. Negro, F. Ninburg, M. Ning, Q. Ntiri- Reid, B. Nymadawa, P. Oevrehus, A. Ormeci, N. Orrego, M. Osman, A. Oyunsuren, T. Pan, C. Papaevangelou, V. Papatheodoridis, G. Popping, S. Prasad, P. Prithiviputh, R. Qureshi, H. Ramji, A. Razavi-Shearer, K. Reddy, R. Remak, W. Richter, C. Ridruejo, E. Robaeys, G. Roberts, S. Roberts, L. Roudot-Thoraval, F. Saab, S. Said, S. Salamat, A. Sanai, F. Sanchez-Avila, J.F. Schiff, E. Schinazi, R. Sebastiani, G. Seguin-Devaux, C. Shanmugam, R.P. Sharara, A. Shilton, S. Shouval, D. Sievert, W. Simonova, M. Sohrabpour, A.A. Sonderup, M. Soza, A. Wendy Spearman, C. Steinfurth, N. Sulkowski, M. Tan, S.-S. Tanaka, J. Tashi, D. Thein, H.-H. Thompson, P. Tolmane, I. Toy, M. Valantinas, J. Van de Vijver, D. Vélez-Möller, P. Vince, A. Waked, I. Wang, S. Wedemeyer, H. Wong, V. Xie, Q. Yamada, S. Yang, H.-I. Yesmembetov, K. Yilmaz, Y. Younossi, Z. Yu, M.-L. Yuen, M.-F. Yurdaydin, C. Yusuf, A. Zekry, A. Zeuzem, S. Polaris Observatory Collaborators

Subjects
digestive system diseases
Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. © 2020 John Wiley & Sons Ltd

Published
2021

2. The case for simplifying and using absolute targets for viral hepatitis elimination goals

Author

Tsendsuren S. Oyunsuren, Chari Cohen, Waseem Hamoudi, Yao‐Chun Hsu, Harry L.A. Janssen, Hisham El Khayat, Manal H El-Sayed, Wan-Long Chuang, Young-Suk Lim, Mohamed Hassany, Fernando Passos Cupertino de Barros, Faisal Abaalkhail, Stefan Zeuzem, Samual S Lee, Miriam T. Levy, Imam Waked, Vassiliki Papaevangelou, James Fung, Erika Castro Batänjer, Kathryn Razavi-Shearer, Boatemaa Ntiri‐ Reid, Rosmawati Mohamed, Pagbajabyn Nymadawa, Robert Flisiak, Alnoor Ramji, Carole Seguin-Devaux, Sherif Mogawer, Béla Hunyady, Huma Qureshi, Mojca Matičič, Martin Lagging, Mark W. Sonderup, Xiaoguang Dou, Anne Oevrehus, William Sievert, Ezequiel Ridruejo, Ann-Sofi Duberg, Ahad Eshraghian, R. P. Shanmugam, Arif Nawaz, Qing Xie, Rick Dunn, Sayed Himatt, Daniel Shouval, Mendez Sanchez Nahum, Sabahattin Kaymakoglu, Vincent Wai-Sun Wong, Soek-Siam Tan, Willis Maddrey, Papu Prasad, Amjad Salamat, Stephanie Popping, Alice Lee, Maurizia Rossana Brunetto, Khalid Alswat, Peyton Thompson, Dong Joon Kim, Henry Chang, Amir Ali Sohrabpour, Ellen Dugan, Peer Brehm Christensen, David A. M. C. van de Vijver, Joaquín Cabezas, Su Wang, Ala I. Sharara, Peter Jarcuska, Karine Lacombe, Danjuma Adda, Sammy Saab, Chien-Jen Chen, Hwai I. Yang, Sanaa Said, Raymond F. Schinazi, Shyamasundaran Kottilil, Graham R. Foster, Qing Ning, Mehlika Toy, Ira M. Jacobson, Ayat R. Abdallah, Laura Cisneros, Dhondup Tashi, Naveed Z. Janjua, Moutaz Derbala, Marcelo Kugelmas, Steven L. Flamm, Angelos Hatzakis, Yusuf Yilmaz, Mark S. Sulkowski, Eugene R. Schiff, Kakharman Yesmembetov, John F. Dillon, Rittoo Prithiviputh, Carlos Eduardo Brandão-Mello, Rajender Reddy, Françoise Roudot-Thoraval, Lewis R. Roberts, Javier Crespo, Massimo Colombo, Nancy Steinfurth, I. M. Hoepelman, Kosh Agarwal, Faisal M. Sanai, Waleed Al-Hamoudi, Shuang Liu, Beat Muellhaupt, Sonjelle Shilton, Curtis Cooper, Calvin Q. Pan, Aijaz Ahmed, Wai-cheung C Lao, Alejandro Soza, Patricia Vélez‐Möller, Ibrahim Altraif, Tarik Asselah, Junko Tanaka, Badr Aljarallah, Adriana Vince, Faryal Khamis, Juan Francisco Sánchez-Ávila, Rafael Esteban Mur, Kimberly A. Brown, Saad Al-Kaabi, Ming-Lung Yu, Jonas Valantinas, Marieta Simonova, Javier García-Samaniego, Do Young Kim, Ieva Tolmane, Valentina Liakina, Antonio Craxì, Devin Razavi-Shearer, Waldemar Halota, Stuart K. Roberts, Donna Cryer, Kenneth Kabagambe, William Remak, Jeffrey V. Lazarus, Brian Conway, Sameera Ezzat, C Wendy Spearman, Karolin Falconer, Maria C Mendes Correa, Poonam Mathur, Ferruccio Bonino, Jose Luis Calleja, Said A. Al-Busafi, E. A. Croes, Tim Block, Shahin Merat, Francesco Negro, Reza Malekzadeh, Fernando L. Gonçales, Amany Zekry, Wahid Doss, Michael Ninburg, Philip Bruggmann, Man-Fung Yuen, George V. Papatheodoridis, Aasim Yusuf, David Kershenobich, Bruce R. Bacon, Abdul Rahman Bizri, Gamal Esmat, Sarah Blach, Hamad Al-Romaihi, Tatsuya Kanto, Ibrahim Mostafa, Homie Razavi, Alessio Aghemo, Mauricio Orrego, Jia-Horng Kao, Daniel Lavanchy, Zobair M. Younossi, Henry Lik-Yuen Chan, Anna Kramvis, David H. Muljono, Clemens Richter, Hla-Hla Thein, Fernando Bessone, Paulo Roberto Abrão Ferreira, Geoffrey Dusheiko, Susan Hay, Geert Robaeys, Eduardo Fassio, Loreta A. Kondili, Jorge Mera, Khalid Al-Naamani, Alaa Osman, Saleh A. Alqahtani, Joseph Doyle, Necati Örmeci, Yee Tak Hui, Heiner Wedemeyer, Laith Jamal Abu Raddad, Masayuki Kurosaki, Rui Tato Marinho, Robert G. Gish, Zaigham Abbas, Seiji Yamada, Giada Sebastiani, Cihan Yurdaydin, Maria Buti, Paulo Ferrinho, Razavi H., Blach S., Razavi-Shearer D., Abaalkhail F., Abbas Z., Abdallah A., Abrao Ferreira P., Abu Raddad L.J., Adda D., Agarwal K., Aghemo A., Ahmed A., Al-Busafi S.A., Al-hamoudi W., Al-Kaabi S., Al-Romaihi H., Aljarallah B., AlNaamani K., Alqahtani S., Alswat K., Altraif I., Asselah T., Bacon B., Bessone F., Bizri A.R., Block T., Bonino F., Brandao-Mello C.E., Brown K., Bruggmann P., Brunetto M.R., Buti M., Cabezas J., Calleja J.L., Castro Batanjer E., Chan H.L.-Y., Chang H., Chen C.-J., Christensen P.B., Chuang W.-L., Cisneros L., Cohen C., Colombo M., Conway B., Cooper C., Craxi A., Crespo J., Croes E., Cryer D., Cupertino de Barros F.P., Derbala M., Dillon J., Doss W., Dou X., Doyle J., Duberg A.-S., Dugan E., Dunn R., Dusheiko G., El Khayat H., El-Sayed M.H., Eshraghian A., Esmat G., Esteban Mur R., Ezzat S., Falconer K., Fassio E., Ferrinho P., Flamm S., Flisiak R., Foster G., Fung J., Garcia-Samaniego J., Gish R.G., Goncales F., Halota W., Hamoudi W., Hassany M., Hatzakis A., Hay S., Himatt S., Hoepelman I.M., Hsu Y.-C., Hui Y.T., Hunyady B., Jacobson I., Janjua N., Janssen H., Jarcuska P., Kabagambe K., Kanto T., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis F., Kim D.J., Kim D.Y., Kondili L.A., Kottilil S., Kramvis A., Kugelmas M., Kurosaki M., Lacombe K., Lagging M., Lao W.-C., Lavanchy D., Lazarus J.V., Lee A., Lee S.S., Levy M., Liakina V., Lim Y.-S., Liu S., Maddrey W., Malekzadeh R., Marinho R.T., Mathur P., Maticic M., Mendes Correa M.C., Mera J., Merat S., Mogawer S., Mohamed R., Muellhaupt B., Muljono D., Mostafa I., Nahum M.S., Nawaz A., Negro F., Ninburg M., Ning Q., Ntiri- Reid B., Nymadawa P., Oevrehus A., Ormeci N., Orrego M., Osman A., Oyunsuren T., Pan C., Papaevangelou V., Papatheodoridis G., Popping S., Prasad P., Prithiviputh R., Qureshi H., Ramji A., Razavi-Shearer K., Reddy R., Remak W., Richter C., Ridruejo E., Robaeys G., Roberts S., Roberts L., Roudot-Thoraval F., Saab S., Said S., Salamat A., Sanai F., Sanchez-Avila J.F., Schiff E., Schinazi R., Sebastiani G., Seguin-Devaux C., Shanmugam R.P., Sharara A., Shilton S., Shouval D., Sievert W., Simonova M., Sohrabpour A.A., Sonderup M., Soza A., Wendy Spearman C., Steinfurth N., Sulkowski M., Tan S.-S., Tanaka J., Tashi D., Thein H.-H., Thompson P., Tolmane I., Toy M., Valantinas J., Van de Vijver D., Velez-Moller P., Vince A., Waked I., Wang S., Wedemeyer H., Wong V., Xie Q., Yamada S., Yang H.-I., Yesmembetov K., Yilmaz Y., Younossi Z., Yu M.-L., Yuen M.-F., Yurdaydin C., Yusuf A., Zekry A., Zeuzem S., Medical Microbiology & Infectious Diseases, Virology, and Negro, Francesco

Subjects
ddc:616, Carcinoma, Hepatocellular, Hepatology, Hepatitis, Viral, Human, business.industry, Liver Neoplasms, ddc:616.07, medicine.disease, World Health Organization, Virology, digestive system diseases, Goal, Infectious Diseases, Absolute (philosophy), SDG 3 - Good Health and Well-being, medicine, Humans, Viral hepatitis, business, Goals, Human
Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.

Published
2021

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