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1. Lives saved with vaccination for 10 pathogens across 112 countries in a pre-COVID-19 world.

Author

Toor J, Echeverria-Londono S, Li X, Abbas K, Carter ED, Clapham HE, Clark A, de Villiers MJ, Eilertson K, Ferrari M, Gamkrelidze I, Hallett TB, Hinsley WR, Hogan D, Huber JH, Jackson ML, Jean K, Jit M, Karachaliou A, Klepac P, Kraay A, Lessler J, Li X, Lopman BA, Mengistu T, Metcalf CJE, Moore SM, Nayagam S, Papadopoulos T, Perkins TA, Portnoy A, Razavi H, Razavi-Shearer D, Resch S, Sanderson C, Sweet S, Tam Y, Tanvir H, Tran Minh Q, Trotter CL, Truelove SA, Vynnycky E, Walker N, Winter A, Woodruff K, Ferguson NM, and Gaythorpe KA

Subjects
Bacterial Infections epidemiology, Humans, Bacterial Infections prevention & control, Bacterial Vaccines therapeutic use, COVID-19, Global Health, Models, Biological, SARS-CoV-2
Abstract

Background: Vaccination is one of the most effective public health interventions. We investigate the impact of vaccination activities for Haemophilus influenzae type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae , and yellow fever over the years 2000-2030 across 112 countries., Methods: Twenty-one mathematical models estimated disease burden using standardised demographic and immunisation data. Impact was attributed to the year of vaccination through vaccine-activity-stratified impact ratios., Results: We estimate 97 (95%CrI[80, 120]) million deaths would be averted due to vaccination activities over 2000-2030, with 50 (95%CrI[41, 62]) million deaths averted by activities between 2000 and 2019. For children under-5 born between 2000 and 2030, we estimate 52 (95%CrI[41, 69]) million more deaths would occur over their lifetimes without vaccination against these diseases., Conclusions: This study represents the largest assessment of vaccine impact before COVID-19-related disruptions and provides motivation for sustaining and improving global vaccination coverage in the future., Funding: VIMC is jointly funded by Gavi, the Vaccine Alliance, and the Bill and Melinda Gates Foundation (BMGF) (BMGF grant number: OPP1157270 / INV-009125). Funding from Gavi is channelled via VIMC to the Consortium's modelling groups (VIMC-funded institutions represented in this paper: Imperial College London, London School of Hygiene and Tropical Medicine, Oxford University Clinical Research Unit, Public Health England, Johns Hopkins University, The Pennsylvania State University, Center for Disease Analysis Foundation, Kaiser Permanente Washington, University of Cambridge, University of Notre Dame, Harvard University, Conservatoire National des Arts et Métiers, Emory University, National University of Singapore). Funding from BMGF was used for salaries of the Consortium secretariat (authors represented here: TBH, MJ, XL, SE-L, JT, KW, NMF, KAMG); and channelled via VIMC for travel and subsistence costs of all Consortium members (all authors). We also acknowledge funding from the UK Medical Research Council and Department for International Development, which supported aspects of VIMC's work (MRC grant number: MR/R015600/1).JHH acknowledges funding from National Science Foundation Graduate Research Fellowship; Richard and Peggy Notebaert Premier Fellowship from the University of Notre Dame. BAL acknowledges funding from NIH/NIGMS (grant number R01 GM124280) and NIH/NIAID (grant number R01 AI112970). The Lives Saved Tool (LiST) receives funding support from the Bill and Melinda Gates Foundation.This paper was compiled by all coauthors, including two coauthors from Gavi. Other funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication., Competing Interests: JT, SE, XL, KA, EC, HC, AC, Md, KE, MF, IG, TH, WH, DH, JH, KJ, AK, PK, AK, JL, XL, TM, CM, SM, SN, TP, AP, DR, SR, CS, SS, YT, HT, QT, ST, EV, NW, AW, KW, NF, KG No competing interests declared, MJ MLJ has received research funding from Sanofi Pasteur unrelated to the present work, MJ Reviewing editor, eLife, BL BAL reports grants and personal fees from Takeda Pharmaceuticals, personal fees from World Health Organization, outside the submitted work, TP TAP receives support from Emergent Biosolutions for work unrelated to his contribution to this study, HR HR is an employee of Center for Disease Analysis Foundation which has received grants from Gilead Sciences, AbbVie, Zeshan Foundation and EndHep2030 fund for projects unrelated to this work; HBV epidemiology data was funded by a grant from John Martin Foundation (Grant number 24), CT CLT received a consulting payment from GSK in 2018 (outside the submitted work), (© 2021, Toor et al.)

Published
2021
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2. Impact of COVID-19 on global HCV elimination efforts.

Author

Blach S, Kondili LA, Aghemo A, Cai Z, Dugan E, Estes C, Gamkrelidze I, Ma S, Pawlotsky JM, Razavi-Shearer D, Razavi H, Waked I, Zeuzem S, and Craxi A

Subjects
Carcinoma, Hepatocellular virology, Cost of Illness, Global Health, Hepatitis C therapy, Humans, Liver Diseases virology, Models, Theoretical, Time-to-Treatment, World Health Organization, COVID-19 epidemiology, Carcinoma, Hepatocellular mortality, Disease Eradication, Hepatitis C mortality, Liver Diseases mortality
Abstract

Background & Aims: Coronavirus disease 2019 (COVID-19) has placed a significant strain on national healthcare systems at a critical moment in the context of hepatitis elimination. Mathematical models can be used to evaluate the possible impact of programmatic delays on hepatitis disease burden. The objective of this analysis was to evaluate the incremental change in HCV liver-related deaths and liver cancer, following a 3-month, 6-month, or 1-year hiatus in hepatitis elimination programs., Methods: Previously developed models were adapted for 110 countries to include a status quo or 'no delay' scenario and a '1-year delay' scenario assuming significant disruption in interventions (screening, diagnosis, and treatment) in the year 2020. Annual country-level model outcomes were extracted, and weighted averages were used to calculate regional (WHO and World Bank Income Group) and global estimates from 2020 to 2030. The incremental annual change in outcomes was calculated by subtracting the 'no-delay' estimates from the '1-year delay' estimates., Results: The '1-year delay' scenario resulted in 44,800 (95% uncertainty interval [UI]: 43,800-49,300) excess hepatocellular carcinoma cases and 72,300 (95% UI: 70,600-79,400) excess liver-related deaths, relative to the 'no-delay' scenario globally, from 2020 to 2030. Most missed treatments would be in lower-middle income countries, whereas most excess hepatocellular carcinoma and liver-related deaths would be among high-income countries., Conclusions: The impact of COVID-19 extends beyond the direct morbidity and mortality associated with exposure and infection. To mitigate the impact on viral hepatitis programming and reduce excess mortality from delayed treatment, policy makers should prioritize hepatitis programs as soon as it becomes safe to do so., Lay Summary: COVID-19 has resulted in many hepatitis elimination programs slowing or stopping altogether. A 1-year delay in hepatitis diagnosis and treatment could result in an additional 44,800 liver cancers and 72,300 deaths from HCV globally by 2030. Countries have committed to hepatitis elimination by 2030, so attention should shift back to hepatitis programming as soon as it becomes appropriate to do so., Competing Interests: Conflicts of interest S.B., Z.C., E.D., C.E., I.G., S.M. and D.R-S. are employees of the Center for Disease Analysis Foundation (CDAF). CDAF has received funding for this work from the John C. Martin Foundation. Over the past 3 years, CDAF has received research funding from Gilead, AbbVie, and Vaccine Impact Modeling Consortium. CDAF has also received grants from CDC Foundation, John Martin Foundation, ASTHO, Zeshan Foundation, and private donors. L.A.K. has received teaching grants from AbbVie and Gilead. A.A. has received research grants from AbbVie and Gilead, and has participated on advisory boards for MSD, AbbVie, Gilead, Mylan, Intercept, and Alfasigma. J.M.P. has received grants from Abbott, AbbVie, and Gilead. He has also received consulting fees from AbbVie, Gilead, Merck, GSK, and Siemens Healthcare. H.R. has been a member of advisory boards for Gilead, AbbVie, Merck, and VBI Vaccines. All proceeds are donated to CDAF. He is the managing director of Center for Disease Analysis (CDA) and CDAF. I.W. has been an investigator for AbbVie, Novartis, Marcyrl, Onexeo, and Pharco. He has been a speaker and advisory board member for MSD, Bayer, Astra-Zeneca, and Eva-Pharma. S.Z. has received lecture honoraria and consulting fees for AbbVie, Allergan, Gilead, Intercept, Janssen, and Merck/MSD. A.C. has been an advisor and speaker and has received research grants from AbbVie, Bayer, BMS, Gilead, Intercept, and MSD. Please refer to the accompanying ICMJE disclosure forms for further details., (Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Published
2021
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3. Global change in hepatitis C virus prevalence and cascade of care between 2015 and 2020

Author

Blach, Sarah, Terrault, Norah A, Tacke, Frank, Gamkrelidze, Ivane, Craxi, Antonio, Tanaka, Junko, Waked, Imam, Dore, Gregory J, Abbas, Zaigham, Abdallah, Ayat R, Abdulla, Maheeba, Aghemo, Alessio, Aho, Inka, Akarca, Ulus S, Alalwan, Abduljaleel M, Alanko Blomé, Marianne, Al-Busafi, Said A, Aleman, Soo, Alghamdi, Abdullah S, Al-Hamoudi, Waleed K, Aljumah, Abdulrahman A, Al-Naamani, Khalid, Al Serkal, Yousif M, Altraif, Ibrahim H, Anand, Anil C, Anderson, Motswedi, Andersson, Monique I, Athanasakis, Kostas, Baatarkhuu, Oidov, Bakieva, Shokhista R, Ben-Ari, Ziv, Bessone, Fernando, Biondi, Mia J, Bizri, Abdul Rahman N, Brandão-Mello, Carlos E, Brigida, Krestina, Brown, Kimberly A, Brown Jr, Robert S, Bruggmann, Philip, Brunetto, Maurizia R, Busschots, Dana, Buti, Maria, Butsashvili, Maia, Cabezas, Joaquin, Chae, Chungman, Chaloska Ivanova, Viktorija, Chan, Henry Lik Yuen, Cheinquer, Hugo, Cheng, Kent Jason, Cheon, Myeong-Eun, Chien, Cheng-Hung, Chien, Rong-Nan, Choudhuri, Gourdas, Christensen, Peer Brehm, Chuang, Wan-Long, Chulanov, Vladimir, Cisneros, Laura E, Coco, Barbara, Contreras, Fernando A, Cornberg, Markus, Cramp, Matthew E, Crespo, Javier, Cui, Fuqiang, Cunningham, Chris W, Dagher Abou, Lucy, Dalgard, Olav, Dao, Doan Y, De Ledinghen, Victor, Derbala, Moutaz F, Deuba, Keshab, Dhindsa, Karan, Djauzi, Samsuridjal, Drazilova, Sylvia, Duberg, Ann-Sofi, Elbadri, Mohammed, El-Sayed, Manal H, Esmat, Gamal, Estes, Chris, Ezzat, Sameera, Färkkilä, Martti A, Ferradini, Laurent, Ferraz, Maria Lucia G, Ferreira, Paulo R A, Filipec Kanizaj, Tajana, Flisiak, Robert, Frankova, Sona, Fung, James, Gamkrelidze, Amiran, Gane, Edward, Garcia, Virginia, García-Samaniego, Javier, Gemilyan, Manik, Genov, Jordan, Gheorghe, Liliana S, Gholam, Pierre M, Goldis, Adrian, Gottfredsson, Magnus, Gray, Richard T, Grebely, Jason, Gschwantler, Michael, Hajarizadeh, Behzad, Hamid, Saeed S, Hamoudi, Waseem, Hatzakis, Angelos, Hellard, Margaret E, Himatt, Sayed, Hofer, Harald, Hrstic, Irena, Hunyady, Bela, Husa, Petr, Husic-Selimovic, Azra, Jafri, Wasim S M, Janicko, Martin, Janjua, Naveed, Jarcuska, Peter, Jaroszewicz, Jerzy, Jerkeman, Anna, Jeruma, Agita, Jia, Jidong, Jonasson, Jon G, Kåberg, Martin, Kaita, Kelly D E, Kaliaskarova, Kulpash S, Kao, Jia-Horng, Kasymov, Omor T, Kelly-Hanku, Angela, Khamis, Faryal, Khamis, Jawad, Khan, Aamir G, Khandu, Lekey, Khoudri, Ibtissam, Kielland, Knut B, Kim, Do Young, Kodjoh, Nicolas, Kondili, Loreta A, Krajden, Mel, Krarup, Henrik Bygum, Kristian, Pavol, Kwon, Jisoo A, Lagging, Martin, Laleman, Wim, Lao, Wai Cheung, Lavanchy, Daniel, Lázaro, Pablo, Lazarus, Jeffrey V, Lee, Alice U, Lee, Mei-Hsuan, Li, Michael K K, Liakina, Valentina, Lim, Young-Suk, Löve, Arthur, Lukšić, Boris, Machekera, Shepherd Mufudzi, Malu, Abraham O, Marinho, Rui T, Maticic, Mojca, Mekonnen, Hailemichael D, Mendes-Correa, Maria Cássia, Mendez-Sanchez, Nahum, Merat, Shahin, Meshesha, Berhane Redae, Midgard, Håvard, Mills, Mike, Mohamed, Rosmawati, Mooneyhan, Ellen, Moreno, Christophe, Muljono, David H, Müllhaupt, Beat, Musabaev, Erkin, Muyldermans, Gaëtan, Nartey, Yvonne Ayerki, Naveira, Marcelo C M, Negro, Francesco, Nersesov, Alexander V, Njouom, Richard, Ntagirabiri, Rénovat, Nurmatov, Zuridin S, Obekpa, Solomon A, Oguche, Stephen, Olafsson, Sigurdur, Ong, Janus P, Opare-Sem, Ohene K, Orrego, Mauricio, Øvrehus, Anne L, Pan, Calvin Q, Papatheodoridis, George V, Peck-Radosavljevic, Markus, Pessoa, Mário G, Phillips, Richard O, Pimenov, Nikolay, Plaseska-Karanfilska, Dijana, Prabdial-Sing, Nishi N, Puri, Pankaj, Qureshi, Huma, Rahman, Aninda, Ramji, Alnoor, Razavi-Shearer, Devin M, Razavi-Shearer, Kathryn, Ridruejo, Ezequiel, Ríos-Hincapié, Cielo Y, Rizvi, S M Shahriar, Robaeys, Geert K M M, Roberts, Lewis R, Roberts, Stuart K, Ryder, Stephen D, Sadirova, Shakhlo, Saeed, Umar, Safadi, Rifaat, Sagalova, Olga, Said, Sanaa S, Salupere, Riina, Sanai, Faisal M, Sanchez-Avila, Juan F, Saraswat, Vivek A, Sarrazin, Christoph, Sarybayeva, Gulya, Seguin-Devaux, Carole, Sharara, Ala I, Sheikh, Mahdi, Shewaye, Abate B, Sievert, William, Simojoki, Kaarlo, Simonova, Marieta Y, Sonderup, Mark W, Spearman, C Wendy, Sperl, Jan, Stauber, Rudolf E, Stedman, Catherine A M, Su, Tung-Hung, Suleiman, Anita, Sypsa, Vana, Tamayo Antabak, Natalia, Tan, Soek-Siam, Tergast, Tammo L, Thurairajah, Prem H, Tolmane, Ieva, Tomasiewicz, Krzysztof, Tsereteli, Maia, Uzochukwu, Benjamin S C, Van De Vijver, David A M C, Van Santen, Daniela K, Van Vlierberghe, Hans, Van Welzen, Berend, Vanwolleghem, Thomas, Vélez-Möller, Patricia, Villamil, Federico, Vince, Adriana, Waheed, Yasir, Weis, Nina, Wong, Vincent W-S, Yaghi, Cesar G, Yesmembetov, Kakharman, Yosry, Ayman, Yuen, Man-Fung, Yunihastuti, Evy, Zeuzem, Stefan, Zuckerman, Eli, Razavi, Homie A, Polaris Observatory HCV Collaborators, Virology, Blach, Sarah, Terrault, Norah A, Tacke, Frank, Gamkrelidze, Ivane, Craxi, Antonio, Tanaka, Junko, Waked, Imam, Dore, Gregory J, Abbas, Zaigham, Abdallah, Ayat R, Abdulla, Maheeba, Aghemo, Alessio, Aho, Inka, Akarca, Ulus S, Alalwan, Abduljaleel M, Alanko Blomé, Marianne, Al-Busafi, Said A, Aleman, Soo, Alghamdi, Abdullah S, Al-Hamoudi, Waleed K, Aljumah, Abdulrahman A, Al-Naamani, Khalid, Al Serkal, Yousif M, Altraif, Ibrahim H, Anand, Anil C, Anderson, Motswedi, Andersson, Monique I, Athanasakis, Kosta, Baatarkhuu, Oidov, Bakieva, Shokhista R, Ben-Ari, Ziv, Bessone, Fernando, Biondi, Mia J, Bizri, Abdul Rahman N, Brandão-Mello, Carlos E, Brigida, Krestina, Brown, Kimberly A, Brown, Jr, Robert S, Bruggmann, Philip, Brunetto, Maurizia R, Busschots, Dana, Buti, Maria, Butsashvili, Maia, Cabezas, Joaquin, Chae, Chungman, Chaloska Ivanova, Viktorija, Chan, Henry Lik Yuen, Cheinquer, Hugo, Cheng, Kent Jason, Cheon, Myeong-Eun, Chien, Cheng-Hung, Chien, Rong-Nan, Choudhuri, Gourda, Christensen, Peer Brehm, Chuang, Wan-Long, Chulanov, Vladimir, Cisneros, Laura E, Coco, Barbara, Contreras, Fernando A, Cornberg, Marku, Cramp, Matthew E, Crespo, Javier, Cui, Fuqiang, Cunningham, Chris W, Dagher Abou, Lucy, Dalgard, Olav, Dao, Doan Y, De Ledinghen, Victor, Derbala, Moutaz F, Deuba, Keshab, Dhindsa, Karan, Djauzi, Samsuridjal, Drazilova, Sylvia, Duberg, Ann-Sofi, Elbadri, Mohammed, El-Sayed, Manal H, Esmat, Gamal, Estes, Chri, Ezzat, Sameera, Färkkilä, Martti A, Ferradini, Laurent, Ferraz, Maria Lucia G, Ferreira, Paulo R A, Filipec Kanizaj, Tajana, Flisiak, Robert, Frankova, Sona, Fung, Jame, Gamkrelidze, Amiran, Gane, Edward, Garcia, Virginia, García-Samaniego, Javier, Gemilyan, Manik, Genov, Jordan, Gheorghe, Liliana S, Gholam, Pierre M, Goldis, Adrian, Gottfredsson, Magnu, Gray, Richard T, Grebely, Jason, Gschwantler, Michael, Hajarizadeh, Behzad, Hamid, Saeed S, Hamoudi, Waseem, Hatzakis, Angelo, Hellard, Margaret E, Himatt, Sayed, Hofer, Harald, Hrstic, Irena, Hunyady, Bela, Husa, Petr, Husic-Selimovic, Azra, Jafri, Wasim S M, Janicko, Martin, Janjua, Naveed, Jarcuska, Peter, Jaroszewicz, Jerzy, Jerkeman, Anna, Jeruma, Agita, Jia, Jidong, Jonasson, Jon G, Kåberg, Martin, Kaita, Kelly D E, Kaliaskarova, Kulpash S, Kao, Jia-Horng, Kasymov, Omor T, Kelly-Hanku, Angela, Khamis, Faryal, Khamis, Jawad, Khan, Aamir G, Khandu, Lekey, Khoudri, Ibtissam, Kielland, Knut B, Kim, Do Young, Kodjoh, Nicola, Kondili, Loreta A, Krajden, Mel, Krarup, Henrik Bygum, Kristian, Pavol, Kwon, Jisoo A, Lagging, Martin, Laleman, Wim, Lao, Wai Cheung, Lavanchy, Daniel, Lázaro, Pablo, Lazarus, Jeffrey V, Lee, Alice U, Lee, Mei-Hsuan, Li, Michael K K, Liakina, Valentina, Lim, Young-Suk, Löve, Arthur, Lukšić, Bori, Machekera, Shepherd Mufudzi, Malu, Abraham O, Marinho, Rui T, Maticic, Mojca, Mekonnen, Hailemichael D, Mendes-Correa, Maria Cássia, Mendez-Sanchez, Nahum, Merat, Shahin, Meshesha, Berhane Redae, Midgard, Håvard, Mills, Mike, Mohamed, Rosmawati, Mooneyhan, Ellen, Moreno, Christophe, Muljono, David H, Müllhaupt, Beat, Musabaev, Erkin, Muyldermans, Gaëtan, Nartey, Yvonne Ayerki, Naveira, Marcelo C M, Negro, Francesco, Nersesov, Alexander V, Njouom, Richard, Ntagirabiri, Rénovat, Nurmatov, Zuridin S, Obekpa, Solomon A, Oguche, Stephen, Olafsson, Sigurdur, Ong, Janus P, Opare-Sem, Ohene K, Orrego, Mauricio, Øvrehus, Anne L, Pan, Calvin Q, Papatheodoridis, George V, Peck-Radosavljevic, Marku, Pessoa, Mário G, Phillips, Richard O, Pimenov, Nikolay, Plaseska-Karanfilska, Dijana, Prabdial-Sing, Nishi N, Puri, Pankaj, Qureshi, Huma, Rahman, Aninda, Ramji, Alnoor, Razavi-Shearer, Devin M, Razavi-Shearer, Kathryn, Ridruejo, Ezequiel, Ríos-Hincapié, Cielo Y, Rizvi, S M Shahriar, Robaeys, Geert K M M, Roberts, Lewis R, Roberts, Stuart K, Ryder, Stephen D, Sadirova, Shakhlo, Saeed, Umar, Safadi, Rifaat, Sagalova, Olga, Said, Sanaa S, Salupere, Riina, Sanai, Faisal M, Sanchez-Avila, Juan F, Saraswat, Vivek A, Sarrazin, Christoph, Sarybayeva, Gulya, Seguin-Devaux, Carole, Sharara, Ala I, Sheikh, Mahdi, Shewaye, Abate B, Sievert, William, Simojoki, Kaarlo, Simonova, Marieta Y, Sonderup, Mark W, Spearman, C Wendy, Sperl, Jan, Stauber, Rudolf E, Stedman, Catherine A M, Su, Tung-Hung, Suleiman, Anita, Sypsa, Vana, Tamayo Antabak, Natalia, Tan, Soek-Siam, Tergast, Tammo L, Thurairajah, Prem H, Tolmane, Ieva, Tomasiewicz, Krzysztof, Tsereteli, Maia, Uzochukwu, Benjamin S C, Van De Vijver, David A M C, Van Santen, Daniela K, Van Vlierberghe, Han, Van Welzen, Berend, Vanwolleghem, Thoma, Vélez-Möller, Patricia, Villamil, Federico, Vince, Adriana, Waheed, Yasir, Weis, Nina, Wong, Vincent W-S, Yaghi, Cesar G, Yesmembetov, Kakharman, Yosry, Ayman, Yuen, Man-Fung, Yunihastuti, Evy, Zeuzem, Stefan, Zuckerman, Eli, and Razavi, Homie A

Subjects
Viremia/epidemiology, Genotype Distribution, Hepatitis C/epidemiology, Hepatology, Epidemiology, Gastroenterology, Infant, Newborn, COVID-19, Hepacivirus, Hepatitis A, Todays Treatment Paradigm, Infections, Hepatitis C, Future Disease Burden, SDG 3 - Good Health and Well-being, HCV, future disease burden, todays treatment paradigm, genotype distribution, epidemiology, infections, Prevalence, Humans, Human medicine, Viremia, Pandemics, COVID-19/epidemiology
Abstract

Background Since the release of the first global hepatitis elimination targets in 2016, and until the COVID-19 pandemic started in early 2020, many countries and territories were making progress toward hepatitis C virus (HCV) elimination. This study aims to evaluate HCV burden in 2020, and forecast HCV burden by 2030 given current trends. Methods This analysis includes a literature review, Delphi process, and mathematical modelling to estimate HCV prevalence (viraemic infection, defined as HCV RNA-positive cases) and the cascade of care among people of all ages (age =0 years from birth) for the period between Jan 1, 2015, and Dec 31, 2030. Epidemiological data were collected from published sources and grey literature (including government reports and personal communications) and were validated among country and territory experts. A Markov model was used to forecast disease burden and cascade of care from 1950 to 2050 for countries and territories with data. Model outcomes were extracted from 2015 to 2030 to calculate population-weighted regional averages, which were used for countries or territories without data. Regional and global estimates of HCV prevalence, cascade of care, and disease burden were calculated based on 235 countries and territories. Findings Models were built for 110 countries or territories: 83 were approved by local experts and 27 were based on published data alone. Using data from these models, plus population-weighted regional averages for countries and territories without models (n=125), we estimated a global prevalence of viraemic HCV infection of 0.7% (95% UI 0.7-0.9), corresponding to 56.8 million (95% UI 55.2-67.8) infections, on Jan 1, 2020. This number represents a decrease of 6.8 million viraemic infections from a 2015 (beginning of year) prevalence estimate of 63.6 million (61.8-75.8) infections (0.9% [0.8-1.0] prevalence). By the end of 2020, an estimated 12.9 million (12.5-15.4) people were living with a diagnosed viraemic infection. In 2020, an estimated 641 000 (623 000-765 000) patients initiated treatment. Interpretation At the beginning of 2020, there were an estimated 56.8 million viraemic HCV infections globally. Although this number represents a decrease from 2015, our forecasts suggest we are not currently on track to achieve global elimination targets by 2030. As countries recover from COVID-19, these findings can help refocus efforts aimed at HCV elimination. Copyright (C) 2022 Elsevier Ltd. All rights reserved., John C Martin Foundation [2019-G024]; Gilead Sciences [IN-US-987-5808]; AbbVie [4200907861]; ZeShan Foundation [2021-0101-1-CDA-HEP-10]; The Hepatitis Fund; Ministry of Health, Labour and Welfare of Japan [19HC1001], This analysis was funded by a grant from the John C Martin Foundation (2019-G024) through the Polaris Observatory for low-income and middleincome countries. Grants for analyses in high-income countries and territories were provided by Gilead Sciences (IN-US-987-5808) and AbbVie (4200907861). ZeShan Foundation (2021-0101-1-CDA-HEP-10) supported country and regional analyses in Asia and The Hepatitis Fund supported country and regional analyses in Africa. We thank the Epidemiological Research Group on the Burden of Viral Hepatitis and Measures for its Elimination (grant number 19HC1001; led by JT) funded by the Ministry of Health, Labour and Welfare of Japan. We thank the contributors included in the appendix (pp 2-3), who contributed to the country or territory analyses but did not meet authorship requirements.

Published
2022

4. Cost‐effectiveness and economic investment to eliminate chronic hepatitis C in Mexico.

Author

Mooneyhan, Ellen, De la Torre Rosas, Alethse, Serrano, Daniel Bernal, Gamkrelidze, Ivane, Sanchez, Maria Jesus, Kershenobich, David, Sereno, Leandro, and Razavi, Homie

Subjects
CHRONIC hepatitis C, HEPATITIS C, ECONOMIC impact, COST effectiveness, COVID-19
Abstract

In July 2020, the Mexican Government initiated the National Program for Elimination of Hepatitis C (HCV) under a procurement agreement, securing universal, free access to HCV screening, diagnosis and treatment for 2020–2022. This analysis quantifies the clinical and economic burden of HCV (MXN) under a continuation (or end) to the agreement. A modelling and Delphi approach was used to evaluate the disease burden (2020–2030) and economic impact (2020–2035) of the Historical Base compared to Elimination, assuming the agreement continues (Elimination—Agreement to 2035) or terminates (Elimination—Agreement to 2022). We estimated cumulative costs and the per‐patient treatment expenditure needed to achieve net‐zero cost (the difference in cumulative costs between the scenario and the base). Elimination is defined as a 90% reduction in new infections, 90% diagnosis coverage, 80% treatment coverage and 65% reduction in mortality by 2030. A viraemic prevalence of 0.55% (0.50–0.60) was estimated on 1st January 2021, corresponding to 745,000 (95% CI 677,000–812,000) viraemic infections in Mexico. The Elimination—Agreement to 2035 would achieve net‐zero cost by 2023 and accrue 31.2 billion in cumulative costs. Cumulative costs under the Elimination—Agreement to 2022 are estimated at 74.2 billion. Under Elimination—Agreement to 2022, the per‐patient treatment price must decrease to 11,000 to achieve net‐zero cost by 2035. The Mexican Government could extend the agreement through 2035 or reduce the cost of HCV treatment to 11,000 to achieve HCV elimination at net‐zero cost. [ABSTRACT FROM AUTHOR]

Published
2023
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