The challenge of Hepatitis C in Central and South Eastern Europe was at the heart of an event hosted by the MEP Friends of the Liver Interest Group co-chairs Dr Cristian Bușoi, MEP, Dr Biljana Borzan, MEP and Dr Andrey Kovatchev, MEP and co-organised by the European Association for the Study of the Liver (EASL), the European Liver Patients Association (ELPA) and the European Public Health Alliance. Among the speakers where representatives of 6 countries: Mrs Pop, the State Secretary for Health of Romania and Prof. Adrian Streinu Cercel, Prof Jerzy Jaroszewich from Poland and Prof Ligita Jancoriene from Lithuania, Dr Ricardo Baptista Leite, a member of the Portuguese Parliament who has done so much to advocate for a national Hepatitis strategy in his country, EMCDDA, the European Commission, patients representatives from ELPA and Praksis in Greece, and last but not least scientists and clinicians from EASL.

Since the launch of the MEP Friends of the Liver Group and the first Parliamentary event on fighting viral hepatitis in resource-limited Members State taking place two years ago the HCV burden in the EU has attracted a lot of attention from policy makers both at EU level and national level. Some CEE countries have started to invest in ensuring expanded access to HCV medicines, and have seen successes in treatment rates and other have put in place toolkits and national strategies, but many others have yet to do so. However, more often, the focus of this attention has not been on the burden of the disease and the harm it causes but on the high cost of new medical treatments. In addition to the economic and human cost from liver disease, the widespread lack of awareness and screening means there is a “double challenge” when dealing with this disease.

Hepatitis C (HCV) has become a serious public health treat in Europe, with an estimated of 14 million people infected with Hepatitis C (HCV) in the WHO European region, causing over 80,000 deaths per year. It is estimated that more than 15 million people in the European Region are leaving with chronic hepatitis C virus (HCV) infection. Central and Eastern Europe (CEE), show higher prevalence rates and have a much harder burden when compared to Western Europe, which shows an estimated average prevalence of 0.9%. The area is affected by one of the highest rates of HCV prevalence in the EU, but struggles due to limited access to screening, diagnosis and treatment. This event aimed to shine a spotlight and identify how we can improve access to screening, diagnosis and treatment and reduce the burden of HCV.

Dr Cristian Bușoi, MEP pointed out from the introduction that “the situation is particularly acute in Central and South Eastern European Member States that have some of the highest rates of HCV prevalence in the EU but where access to screening, diagnosis and treatment is limited.  This event aims to shine a spotlight on these regions and identify how we can improve access to screening, diagnosis and treatment and reduce the burden of HCV in the region in these countries.”

Dagmar  Hedrich of the European Monitoring Centre for Drugs and Drug Addiction addressed the risk of Hepatitis C infection for People Who Inject Drugs. “Reducing the HCV burden in Europe in the future depends on implementing policies that increase the availability of interventions to prevent and treat HCV among PWID”, Hedrich stated.

“It is completely unacceptable that hepatitis B (HBV) and hepatitis C virus (HCV) continue to be so poorly addressed in Europe. There are excellent prevention and treatment possibilities, well-thought-out strategies are available, and we have numerous international initiatives, especially from WHO. I expect the recent launch of the Hep-CORE study to change the landscape of viral hepatitis policy surveillance on a regional, and even global, level”, commented Tatjana Reic, President of ELPA.

Professor Helena Cortez Pinto of the European Association for the Study of the Liver (EASL)  presented the EASL treatment guidelines for Hepatitis C patients. The guidelines have been drawn up by leading European experts in the field and suggest that there should be universal access to treatment for all patients. It is also necessary to ensure that patients are screened for pre-existing conditions such as kidney and cardiovascular disease as these diseases can affect the success of the treatments offered. Ultimately, the treating physician should be able to decide, in consultation with the patient what the right treatment regimen is for them as an individual.

Yannis Natsis, of the European Public Health Alliance concluded that patients are being let down twice - firstly by dramatic cuts to prevention and public health programmes across Europe, and secondly by the high prices which stand in the way of accessing treatment. An unaffordable treatment is as good as a non-existent one from a patient's perspective.

“More than two-years ago, in this very same room, we assessed the burden of Hepatitis C in resource-limited Member States, and two years after, while there continues to be major structural, clinical, and access challenges, I feel that we are on the right track – on a track that can lead us to the elimination of Hepatitis C in Central and South Eastern Europe”, stated Dr Cristian Bușoi, MEP. His concluding message was: “Engagement, engagement, engagement”. “Only by working all together, we can achieve the path to elimination. Be engaged with all the relevant stakeholders at all levels through collaboration amongst patients, civil society organisations, researchers, the private sector, local and national governments, European Union institutions, and other relevant regional bodies to leverage the expertise and capabilities of all sectors for a comprehensive response.”