Advancing the Viral Hepatitis Action Plan: Checking-In with Federal and Community Leaders

On Tuesday, 10/14/14, the cross-government working group supporting and monitoring the implementation of the updated Viral Hepatitis Action Plan—the Viral Hepatitis Implementation Group or “VHIG”—met in Washington, DC to share updates on 2014 accomplishments and plans for the coming year. Some of the highlights included:

• Promising preliminary data from HRSA’s Bureau of Primary Health Care showing a significant increase in the number of hepatitis C tests conducted in health centers across the U.S. in 2013 and similar promising increases in HCV testing numbers from the Indian Health Service (IHS).
• 34 new SAMHSA grants with a required viral hepatitis component. At the end of fiscal year 2014, SAMHSA made 34 awards of up to $500,000/year each for four years under its new Minority AIDS Initiative Continuum of Care Pilot, which supports the integration of HIV prevention and medical care into mental health and substance abuse treatment programs for racial/ethnic minority populations at high risk for behavioral health disorders and HIV. These new awards require the use of 5% of the grant funds for viral hepatitis prevention, vaccination, testing, and linkage to clinical care.
• New funding opportunities from the National Institute on Drug Abuse (NIDA) for research focused on hepatitis C and awards by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to support eight research centers for work focused on people living with HIV and hepatitis B co-infection.
• The HHS Office of Population Affairs (OPA), which administers the Title X Family Planning program, and CDC released updated, evidence-informed guidelines for the delivery of family planning services that recommend hepatitis B vaccination and hepatitis C screening as part of STD services and preconception care for clients receiving family planning services.
• A new investment totaling of $4.3 million by CDC’s Division of Viral Hepatitis in 3 new grants intended to strengthen health-care capacity to diagnose and cure hepatitis C virus (HCV) infection through implementation of a package of services to target populations with a disproportionate burden of HCV disease. Grantees in Chicago, Maryland, and Seattle/King County have begun this work.
• A recent in-person meeting involving health care providers from all 21 regions (networks) of the Department of Veterans Affairs focused on analyzing systematic barriers to hepatitis C diagnosis and treatment and developing models and strategies to address those barriers and operational gaps.

Later that day, the VHIG met with a diverse gathering of community leaders and stakeholders for a conversation about further opportunities for collaboration. The updated Viral Hepatitis Action Plan underscores that its goals cannot be achieved through federal action alone. Active involvement of and innovation by a broad mix of stakeholders from various sectors, both public and private, are essential. The updated plan provides a framework and a focus around which key stakeholders can engage to strengthen our nation’s response to viral hepatitis.

“I’ve heard from many colleagues across stakeholder communities about activities they are undertaking that support the goals of the Viral Hepatitis Action Plan,” observed Corinna Dan, R.N., M.P.H., the Viral Hepatitis Policy Advisor, in the HHS Office of HIV/AIDS and Infectious Disease Policy. “I was pleased that so many could participate in this productive conversation with federal partners about ways to leverage, amplify, and extend each other’s efforts to confront the silent epidemic of viral hepatitis in the U.S."

Participants in the afternoon dialogue included representatives of hepatitis B and hepatitis C patient advocacy groups, healthcare provider associations, health departments, and other key allies in this work. (View list of participants in stakeholder meeting.) Among the issues explored were stakeholder activities that are advancing the Viral Hepatitis Action Plan as well as opportunities for further collaboration. Some of the actions underway include:

• Several participating organizations referenced using the Viral Hepatitis Action Plan as a key tool in their work to educate legislators and other policy makers at all levels of government about the importance of strengthening local, state, and national responses to viral hepatitis. The Action Plan provides a framework to put state and local efforts into the context of what is occurring nationally.
• The Hep B UnitedExit Disclaimer coalition used the Viral Hepatitis Action Plan and Stakeholder’s Workbook referenced use of the Stakeholder’s Workbook during a recent strategic planning meeting focused on addressing health disparities in viral hepatitis.
• The Global Liver InstituteExit Disclaimer is working to increase awareness of viral hepatitis by expanding its work with faith-based communities as well as its work with the entertainment industry to deliver messages about liver health and hepatitis treatment into TV and movies.
• Led by The AIDS InstituteExit Disclaimer, work is underway by stakeholders in Florida to pass state legislation requiring health care providers to offer hepatitis C testing to individuals in the 1945-1965 birth cohort, similar to a New York state law that went into effect earlier this year.

Discussion participants also encouraged:

• Continued efforts on the part of all parties to develop and deliver motivational messages for members of the 1945-1965 birth cohort (a.k.a. “baby boomers) and their health care providers about the importance of HCV screening as recommended by both CDC and the U.S. Preventive Services Task Force. Several stakeholders noted that not all members of this population can be effectively reached via online messages, so a variety of approaches are needed.
• Improving messaging about the fact that HCV screening is now among the covered preventive services that insurance plans must cover without charging co-pays for individuals in the 1945-1965 birth cohort as well as individuals at high risk of infection.
• Highlighting successes that health departments and others have had in making the most of available flexibilities in uses of funds for testing for a variety of infectious diseases, including HIV, HCV, and HBV.
• Continued focus on the importance of working to improve the health of drug users and clearly stating that the lives of drug users matter.

We were pleased to hear from one stakeholder representative who endorsed our efforts to communicate about the Viral Hepatitis Action Plan and provide timely updates about activities related to viral hepatitis via blog posts such as this one. We plan to continue sharing posts about federal and non-federal activities in support of the Viral Hepatitis Action Plan.

All of the VHIG members agreed that it was very helpful to hear directly from the stakeholders who offered updates on their own work and/or suggestions on steps they feel that federal agencies or programs could take. Continuing this dialogue is essential as we continue to implement the Viral Hepatitis Action Plan and strive to achieve its lifesaving goals.