The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations

Semin Liver Dis. 2018 Aug;38(3):181-192. doi: 10.1055/s-0038-1666841. Epub 2018 Jul 9.

Abstract

The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV, and it can build momentum by producing small victories that inspire more ambitious efforts. The micro-elimination approach encourages stakeholders who are most knowledgeable about specific populations to engage with each other and also promotes the uptake of new models of care. Examples of micro-elimination target populations include medical patients, people who inject drugs, migrants, and prisoners, although candidate populations can be expected to vary greatly in different countries and subnational areas.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Cooperative Behavior
  • Delivery of Health Care, Integrated / legislation & jurisprudence
  • Delivery of Health Care, Integrated / organization & administration*
  • Disease Eradication / legislation & jurisprudence
  • Disease Eradication / organization & administration*
  • Global Health* / legislation & jurisprudence
  • Health Policy* / legislation & jurisprudence
  • Hepatitis C / ethnology
  • Hepatitis C / prevention & control*
  • Hepatitis C / transmission
  • Humans
  • Interdisciplinary Communication
  • International Cooperation
  • Models, Organizational*
  • Policy Making
  • Prevalence
  • Risk Factors
  • Stakeholder Participation
  • Vulnerable Populations

Substances

  • Antiviral Agents