Q: What brought you to Hepatitis C advocacy and can you describe your work at The AIDS Institute? How do viral hepatitis efforts fit in with AIDS Institute’s advocacy on HIV?
I’ve been fortunate enough to spend my career helping people access better healthcare, safer workplaces, and stronger communities. I started working in the implementation of the Affordable Care Act (ACA), which solidified my focus on public health and how it affects not only individuals, but also entire communities. As I advanced through my career and the opportunity with The AIDS Institute around Hepatitis C came up, I realized that we were just resources and dedicated personnel hours away from eliminating this infectious disease – and jumped right in.
Working in the progressive and LGBTQ community gave me experience with the impact of HIV, so working with an issue directly tied to HIV is another big reason I moved into the viral hepatitis space. We can’t talk about HIV health unless we also talk about viral hepatitis health. About a third of people living with HIV in the U.S. are also co-infected with viral hepatitis, either Hepatitis C or B. Persons with HIV and viral hepatitis have worse health outcomes than those persons who have viral hepatitis but are not infected with HIV.
At The AIDS Institute, we advocate a syndemic approach to viral hepatitis elimination by leveraging not only best practices, but also the existing public health infrastructure for HIV, STDs, and other infectious diseases. For example, if someone gets an HIV test, they should get tested for viral hepatitis at the same time.
In addition to screening, there are connections within HIV treatment programs, such as the Ryan White HIV/AIDS program, to provide viral hepatitis care for co-infected patients. Viral hepatitis advocates also keep updated on the U.S. Department of Health and Human Services (HHS)’ Ending the HIV Epidemic: A Plan for America (EHE) plan, because it provides an infrastructure framework that can also positively impact viral hepatitis in the country by expanding provider locations and scope of programs to attract people living with viral hepatitis. The AIDS Institute and various viral hepatitis organizations will participate in advocacy days with other infectious disease groups to work together, because these diseases are very much intertwined. There is a huge syndemic focus on these diseases, including injection drug use and lack of sterile injection equipment.
Q: What is the current landscape of viral hepatitis funding in the U.S.? How does it compare to other diseases, and has it been impacted by the COVID-19 pandemic?
The current funding landscape for viral hepatitis in the U.S. is abysmal – but improving. We have had some success generating additional funding from Congress over the last four or five fiscal years, but it is still dramatically less than what we need.
The Centers for Disease Control and Prevention’s Division of Viral Hepatitis received core prevention and surveillance funding of less than $40 million in fiscal year 2021. According to experts, the CDC needs nearly ten times that amount to put the U.S. on a path toward elimination. Viral hepatitis funding is significantly lower than dedicated funding for other infectious diseases, and that must be increased to effectively mount an elimination campaign. We urge Congress and the administration to do that in conjunction with funding to combat the opioid crisis, because the increasing incidence of Hepatitis C is directly tied to injection drug use and lack of sterile injection equipment.
We also urge Congress to bolster funding for the entire public health system, because a stronger system will help identify and contain viral hepatitis outbreaks, and to take a syndemic approach that allows state and local programs flexibility to address multiple infectious diseases at once. Many of the populations at increased risk for viral hepatitis are also at increased risk for HIV, STDs, and COVID-19.
The impact of COVID-19 on viral hepatitis funding is complex. State and local budgets have taken a hit in the last year, and we are concerned that there may be budget cuts that could set back viral hepatitis programs as a result. Many of those programs had to reduce their activities in 2020 because of COVID-19, and we expect to see an increase in unmet need in 2021. Congress did not allocate any hepatitis-specific funding as part of the COVID-19 stimulus packages in 2020, but we will be advocating for that this year. That said, COVID-19 has also really put a spotlight on the value of a strong public health system, and what happens when that system is neglected. We hope that will spur some members of Congress to champion increasing funding to fight infectious diseases, including viral hepatitis.
TO CONTINUE READING: https://hepvu.org/hepvu-qa-frank-hood-on-the-importance-of-funding-viral-hepatitis-elimination/