Statement by Vytenis Andriukaitis,
EU Commissioner for Health and Food Safety
Worldwide, viral hepatitis B and C affect 325 million people. It is a significant global health threat, causing two in every three liver cancer deaths, and 1.34 million deaths a year, whilst 300 million people living with viral hepatitis are unaware they have it. The Sustainable development goals agreed in 2015 explicitly mentioned combatting hepatitis as a separate disease for the first time, testimony to its considerable world health burden. The EU has pledged its commitment and stands ready to play its role to support Member States in their efforts at fighting this epidemic.
In the EU/EEA, an estimated 96,000 people die each year from HBV and HCV related liver disease (1). One of the biggest issues with hepatitis B and C is that they are often asymptomatic, with symptoms not showing sometimes for years or decades. Hepatitis is preventable, which is why health promotion and prevention are key. This is also why early detection, sufficient monitoring, prompt diagnosis and fast linkage to necessary treatment are imperative. Specifically for hepatitis B, vaccination is central to prevention efforts.
In the EU/EEA there is an estimated total of 4.7 million chronic HBV cases and 5.6 million HCV infected cases (2) . The most vulnerable groups often particularly affected include people who inject drugs, sex workers, prisoners, migrants and men who have sex with men who are also at higher risk of co-infection with other diseases such as HIV. As these groups are often socially marginalised and may face difficulties with insufficient access to prevention and health care services, sustained efforts at outreach and tailored prevention interventions are needed to tackle the epidemic.
In order to reduce hepatitis, the Commission recognises the need for all stakeholders to work together to link policy makers, researchers, medical and healthcare professionals, and patients. The Commission maintains regular policy dialogue with Member States and civil society organisations. Several EU agencies also provide support to countries in their efforts to address hepatitis. The European Centre for Disease Prevention and Control (ECDC) is a key agency by providing surveillance, scientific advice, capacity building, information and exchange of good practice. A strengthened EU cooperation on Health Technology Assessment (HTA) can also greatly help by improving the functioning of the Single Market for health products, ensuring that the formulation of health policies are harmonised enabling them to be safe, effective , patient focused and cost effective. A legislative proposal on EU wide HTA was adopted by the European Commission on 31 January 2018 and it is sent to the European Parliament and the Council with the aim of adoption by 2019.
The EU Health Programme finances viral hepatitis activities in the area of public health, in particular in targeting the most vulnerable, as well as in placing a strong focus on improving access to testing and care. Examples of EU Health Programme projects include the INTEGRATE Joint Action of 29 partners from public health institutions, hospitals, NGOs and universities across 15 EU countries to integrate early diagnosis and linkage to prevention and care of viral hepatitis, HIV, TB and STIs in EU countries by 2020. The EU has co-funded INTEGRATE by nearly EUR 2 million. Another project, HEPCARE, with EU co-funding of EUR 1 million, aims to support the development of national hepatitis strategies, screening and treatment guidelines, taking into account available treatment options. It will help to bridge primary, secondary care, and outreach in the community to facilitate access to and uptake of testing and treatment services particularly among key risk groups including drug users and homeless.
The Commission has just published a ''Staff Working Document on combatting HIV/AIDS, viral hepatitis and tuberculosis in the European Union and neighbouring countries'' which aims to provide decision makers, stakeholders, and citizens with an overview of effective policies in the prevention, control and treatment of HIV/AIDS, viral hepatitis and tuberculosis.
My belief in the necessity to strongly focus on disease prevention and health promotion remains steadfast. The more health systems invest in prevention now, the less they will pay in treatment costs in the future, and indeed save lives. Today, on World Hepatitis Day, it is important to reaffirm our commitment to collectively ensure our joint efforts to eliminate hepatitis – this 'silent epidemic' – are reinforced. I continue to hope that we will achieve this goal, together.
27 July 2018