Swiss Hepatitis Symposium 2018 «Political will is needed»

HIV pioneer Michel Kazatchkine addresses the participants (photo: Patientube)

«It is clear where the wind blows from on the international level», with these words Michel Kazatchkine, former Global Fund Director and HIV pioneer, opened the Swiss Hepatitis Symposium 2018. The integration of hepatitis in all programs is needed. «Mainstreaming» is the keyword today. The most affected populations must be at the center of all activities fighting hepatitis, as we learnt in the fight against HIV. After all, this is also a question of human rights, of the right to health care for all, as professor Kazatchkine explained.

The symposium was attended by over 70 people from all over Switzerland and with a wide variety of professional backgrounds. The first half of the event addressed the gaps in the care for patients. Andrea Bregenzer from the Cantonal Hospital Aarau, together with the infectious disease specialist Claude Scheidegger, presented the strikingly large gaps in the cascade of care for a high-risk group; injecting drug users. But even with little efforts, the viral load in this group can be drastically and sustainably reduced. For the men who have sex with men MSM, the Swiss HCVree Trial, presented by infectious disease specialist Dominique Braun, shows the opportunity of micro elimination of hepatitis C in this group. Andreas Lehner, Managing Director of the Swiss Aids Federation, showed, why it is important to know the behavior of the community to do effective prevention work. Frightening also the situation in Swiss prisons: The widespread practice of tattooing and the often limited access to testing and therapies was impressively demonstrated by prison doctor Professor Hans Wolff from Geneva. There is still a lot to do in this setting.

To jointly tackle HIV and hepatitis

The second half was all about elimination. National Councilor Barbara Gysi pleaded in her words for a joint approach to fighting HIV and hepatitis. The Federal Office of Public Health should be more active. Bettina Maeschli, Managing Director of Hepatitis Switzerland, presented the first successes of the strategy and pointed out that Switzerland will hardly reach the elimination goals of the WHO in regards to the declining treatment numbers of hepatitis C patients. Infectious disease specialist Jan Fehr made a dedicated plea for "passion and courage" in the fight against hepatitis, just as it was and is still the case for HIV. It would be necessary to promote the elimination of HIV and hepatitis and to "marry" the two. Finally, infectious disease specialist Greg Dore from Sidney, Australia, reported on the exemplary Australian elimination strategy. Australia has had a strategy for hepatitis for decades and is well on track on its way to elimination. Thanks to an innovative system of drug prices that the government has been able to negotiate with pharmaceutical companies - the government has been able to cap the spendings for therapies over five years, the bigger the number of treated patients, the smaller the price for one treatment - and a large proportion of those affected have already been treated. Furthermore, the also GPs can prescribe hepatitis C therapies unlike in Switzerland. And there is a strong focus on risk groups. It was impressive to see how excellent the data in Australia are to monitor the elimination.

Switzerland has everything it needs to play a pioneering role in hepatitis, as it is already doing in HIV. But there is a lack of awareness and political will. We have a unique opportunity to eliminate a dangerous infectious disease. We should and can do it.

We thank the sponsors Abbvie, Swiss Aids Federation, Arud Centers for Addiction Medicine, Federal Office of Public Health, Gilead, Swiss Cancer League, Swiss Association for the Study of the Liver SASL for their valuable support.

To the presentations

1_A. Bregenzer und C. Scheidegger: People who inject drugs
2_D. Braun: Microelimination - A Promising Approach in Ending Hepatitis C
3_A. Lehner: A Short View on the MSM Prevention Side
4_H. Wolff: Filling the Gaps in Prisons
5_B. Maeschli: Swiss Hepatitis Strategy - Where are we today
6_J. Fehr: What can we learn from HIV/Aids?
7_G. Dore: Australia - About to eliminate hepatitis C?