In May 2014, Switzerland signed the WHO resolution to combat viral hepatitis. With its signature, Switzerland committed to formulating a national strategy.
A group of over 70 honorary ambassadors such as medical specialists, economists, representatives of peer groups, insurers and politicians have started to draw up such a strategy. The process started in January 2014 with an introductory meeting, attended, among others, by former president of Switzerland Ruth Dreifuss, UN special envoy Michel Kazatchkine and MP Yvonne Gilli.
The strategy aims to reduce the individual, medical, and socio-economic impact of the hepatitis epidemic in Switzerland with patient-friendly, cost-efficient and implementable measures. The currently debated high prices of hepatitis C medication and their sensible application should form part of the strategy as well as measures to prevent new infections, optimise treatment and reduce cases of secondary illnesses and deaths caused by viral hepatitis.
The national hepatitis strategy wants to eradicate viral hepatitis within the next 15 years. To eradicate means to reduce infection rates to zero, whereas continuing efforts will be needed to prevent the recurrence of infections.
This vision shall be reached by the following three goals:
Reducing the social-economic consequences of viral hepatitis for each individual, high-risk groups and the general public
Growing numbers of illnesses and deaths caused by viral hepatitis has placed a heavy burden on public health with negative social and economic consequences. Hepatitis C has lead to stigmatisation and discrimination. Higher awareness of the disease, more diagnoses and well directed treatment as well as price reductions for hepatitis C medicines, for example through a quantity-dependent pricing system, could lighten this burden.
Reducing the transmissions of hepatitis B and hepatitis C
It is estimated that over 50 per cent of people infected have not been tested, know nothing of their illness and that they can potentially pass the virus on to others. Therefore, the primary goal has to be: considerably higher diagnosis and treatment rates and improved prevention in population groups that are particularly vulnerable to infections. Furthermore, people with undiagnosed infections, who can potentially increase the progression of the disease among the general public, need to be identified and treated. Hepatitis B infection rates can be reduced by optimizing vaccination for the general public. The goal is reducing new infections by 30 per cent in five years and by 90 per cent in fifteen years.
Reducing morbidity and mortality rates caused by viral hepatitis
The following results want to be achieved:
Hepatitis C: 30 per cent fewer chronic infections in five years, and none in fifteen years.
Hepatitis B: 20 per cent fewer chronic infections in five years, and 80 per cent in fifteen years.
Liver transplants: 30 per cent fewer liver transplants caused by viral hepatitis in five years, and none by 2030.
Liver cancer caused by viral hepatitis: 30 per cent fewer cases in five years and none in fifteen years.
Vision and goals are based on the present state of the debate. They can be discussed and adjusted to new findings at any time. They are considered important guiding principles to help determine future actions.
The network consists of over 80 honorary specialists, who represent all relevant aspects of hepatitis. They meet twice a year to discuss the hepatitis strategy.
In September 2014, the network identified areas of importance and set up working groups accordingly. At present, they are working on “Education and Prevention”, “Testing and Monitoring”, “Treatment”, “High-Risk Groups”, “Funding and Pricing” and “Politics”. A liaison officer in each group acts as intermediary between the working groups and the supporting organisations.
The network and its working groups are responsible for the development and implementation of a strategy.
Project management is responsible for the operational aspects of the strategy development such as organising meetings, scheduling, coordinating activities of the working groups, budgets, fundraising and communication.
The strategy is supported by the medical associations Swiss Experts in Viral Hepatitis (SEVHep), the Swiss Society of Gastroenterology (SGG), the Swiss Association for the Study of the Liver (SASL) and the Swiss Society for Infectious Diseases (SSI), the Positive Council and the Global Health Program (GHP) of the Graduate Institute Geneva.