1. Federal Welcome: A View from the Office of HIV/AIDS and
Infectious Disease
Policy Director
Office of the Assistant Secretary for Health
NASTAD Hepatitis Technical Assistance Meeting
December 6, 2016
The findings and conclusions expressed in this presentation are those of the author and do not necessarily represent the views of the Department of Health and Human Services 1

2. Collective Efforts
With special recognition and thanks to Corinna Dan

3. Potential Opportunities and Challenges Selected HHS Efforts
Overview
Potential Opportunities and Challenges
Selected HHS Efforts
Viral Hepatitis Implementation Group
HHS Viral Hepatitis Webpages
Use of Federal Funds for SSP
Curing HCV among Persons Living with HIV
National Viral Hepatitis Action Plan

4. Potential Opportunities and Challenges
Every change brings the potential for new opportunities and challenges
Priorities of the new administration are not fully known re: hepatitis issues
We are committed to providing and advocating for evidence-based decsions
Some state programs operate under Republican leaders, others under Democratic leadership

5. Viral Hepatitis Implementation Group
Coordinates efforts across federal agencies
23 federal departments, agencies and offices including HHS, DOJ, HUD, and VA
Major efforts include:
Development, implementation, and monitoring of the National Viral Hepatitis Action Plan
Information sharing
More consistent federal communications

6. HHS Viral Hepatitis Webpages

7. Use of Federal Funds for SSPs
HHS guidance released on March 29, 2016
Allows federal funds to support operational components of SSPs under certain circumstances
Agency-specific guidance from CDC, HRSA, SAMHSA
Requires concurrence on determination of need by CDC
As of 10/13: 21 requests and 17 approvals

8. Improving Access to HCV Treatment
CMS letter to state Medicaid directors in November 2015
Ongoing monitoring and follow up
Expert Meeting on Improving Access to Early HCV Treatment (September 2016)
34 stakeholders representing public and private payers, health care providers, researchers, advocates, and federal partners
Examined costs and economic benefits, barriers and effective health care models, data and policy gaps; strategies to strengthen the business case
Meeting summary will be posted online

9. Curing HCV in Persons Living with HIV
Secretary’s Minority Initiative Fund
$10 million to HRSA HAB (FY16-19)
Jurisdictional Approach to Curing HCV among Coinfected People of Color
3 demonstration sites (Hartford, New York, Philadelphia)
State Health Department Coordinating Center (NASTAD)
Evaluation and Technical Assistance Center (RAND)
AIDS Education and Training Center

10. National Viral Hepatitis Action Plan
A road map for our nation’s response to
viral hepatitis
Promotes action, transparency, and accountability
Sets goals, priorities, and measurable targets
Actions to be taken
Currently being updated to 2020 10

11. The Evolution of Our National Response 11

12. Status of Viral Hepatitis 2011 - 2014
Baseline Estimate (Source)
Year of Baseline Estimate
Measure
Future Source of Data
2014
2020 Goal
Goal 1: Increase the proportion of persons who are aware of their chronic HBV infection from 33% to 66%.
33%
(REACH Survey /NHANES)
2009
Proportion of persons with HBV infections who know that they are infected
NHANES
(No change)
66%
Goal 2: Increase the proportion of persons who are aware of their chronic HCV infection from 45% to 66%.
45%
(NHANES)
2010
Proportion of persons with HCV infections who know that they are infected
54%
(Increased)
Goal 3: Reduce the number of new cases of HCV infection by 25%.
1,229
(NNDSS)
2011
Number of reported and estimated acute hepatitis C cases in the United States
NNDSS
2,195
922
Goal 4: Eliminate mother-to-child transmission of HBV.
747 (Unstable Estimate)
(NVSS)
Number of infants perinatally infected with HBV
NVSS
952
No cases*
64.1%
(NIS)
Hepatitis B vaccine “birth dose” coverage
NIS
72.4%
85% 12

13. NVHAP Development Action Plan update for 2017-2020
The Viral Hepatitis Implementation Group (VHIG) leading update and implementation
23 federal agencies from HHS, DOJ, VA, HUD, and the White House
March – June 2016 conducted 12 hepatitis stakeholder calls, webinars, and meetings with non-federal partners to gather input on the updated Action Plan 13

14. NVHAP Vision 14

15. Updating our National Viral Hepatitis Action Plan for 2017 - 2020
4 National Goals
Prevent New Viral Hepatitis Infections
Reduce Deaths and Improve the Health of People Living with Viral Hepatitis
Reduce Viral Hepatitis Health Disparities
Coordinate, Monitor, and Report on Implementation of Viral Hepatitis Actions 15

16. Measuring Progress on Viral Hepatitis
17 viral hepatitis indicators
4 Prevent new viral hepatitis infections
4 Reduce deaths and improve the lives of people with chronic hepatitis
9 Reduce viral hepatitis health disparities
* Indicators align with HP 2020 and the CDC’s (NCHHSTP) 2020 goals 16

17. Considerations: Elimination
National Academies of Sciences, Engineering and Medicine (formerly IOM)
Released report on April 11, 2016
Committee determined that:
Both hepatitis B and C could be rare diseases in the US
Considerable will and resources would be required to do this
Follow-up report in April 2017 will address what steps must be taken
Available at: nas.edu/hepatitiselimination 17

18. Critical Gaps in the Viral Hepatitis Response
Viral hepatitis infections are increasing rather than moving toward elimination because of the opioid epidemic.
There are critical gaps in the response to viral hepatitis that make elimination difficult.
Existing resources do not support active surveillance in all states,
Prevention messages and programs do not have sufficient reach,
Screening recommendations are not being fully implemented, and
Many people with viral hepatitis are not able to access timely treatment to prevent disease progression and onward transmission. 18

19. Key partner pre-briefings (1-2 weeks before launch) Partner webinar
NVHAP Roll Out Plan
Key partner pre-briefings (1-2 weeks before launch)
Partner webinar
Materials
Action Plan, Federal Work Plan
1 pager, slides, blogs, digital tools, infographics 19

20. We can only achieve our vision if we all do our part and work effectively and strategically with each other.