The UAE is on course to eliminate hepatitis C within a decade with the help of a new strategy to wipe out the virus in “baby steps”.
The process of ‘micro-elimination’, which targets specific communities or at-risk groups one by one for screening and treatment, would help detect cases and treat patients who might not even know they had the condition, experts said.
The approach was trialled in Ras Al Khaimah and is set to be adopted by the Ministry of Health, Samir Alawadi, a consultant gastroenterologist and President of Emirates Gastroenterology and Hepatology Society, said.
The tactic means specific groups in a community will be identified and targeted by health workers, rather than the population as a whole.
For example, those at greater risk, such as those who undergo blood transfusions, could be prioritised with interventions.
Agreements between authorities, hospitals and insurance providers in the UAE can then see expensive treatment provided for the virus, which primarily affects the liver and can cause fatal cirrhosis and liver cancer if left untreated, for all residents.
The UAE has previously said it intends to eliminate the disease by 2030, in line with World Health Organisation goals to drastically reduce prevalence.
“Along with micro-elimination strategies and the new approved treatments available within the UAE, I think this target can be met within the next 10 years,” Dr Alawadi said.
“While prevalence rates in the UAE are low, collaboration between governments, primary care providers, other healthcare specialists, policy makers and pharma companies is key to achieving the WHO elimination targets.
“Efforts so far have proven to be successful, however, further simplifying the approach by creating a strategic plan to break down national elimination goals into smaller achievable goals for individual populations, and working collaboratively, will really support to maintain momentum of elimination efforts.”
There are an estimated 170 million carriers of Hepatitis C around the world and the Middle East and North Africa regions have the highest regional infection rates. The virus causes approximately 399,000 fatalities each year worldwide, according to WHO.
The prevalence in the UAE ranges from 0.24 to 1.64 per cent of the population. But medics have said up to 70 per cent of patients remain undiagnosed.
“There’s been a revolution in the treatment of hepatitis B and C, which are major killers,” Stefan Wiktor, Professor in the Department of Global Health at the University of Washington, Seattle, who attended a conference about micro-elimination in Dubai this year, said.
“Around 1.4 million people die from chronic viral hepatitis B and C every year but now there’s an effective treatment for both.”
While overall infection rates in the UAE are low, he said among some small sub-groups of the population, hepatitis C rates could be far higher. For example, among people who inject drugs, it could be as high as 50 per cent, he said.
“The challenge that many countries have had is the fact that it’s all a bit overwhelming,” Professor Wiktor said. “The sheer number of people that need to be tested and treated seems daunting so, the concept of micro-elimination is an idea of carrying out the task in baby steps.
“You could pick a city or region and really develop a plan and try to tackle the issue in a smaller area to show that it’s possible and to learn lessons that could then be applied on a national level.
“Basically, this is an idea that simplifies national elimination by identifying a more feasible, more practicable population or group in which you could try to achieve elimination more rapidly.”