Hepatitis C

Lord Patel Excerpts

Monday 9th July 2018 Lords Chamber

[Lord O'Shaughnessy]

The first thing I would say to the noble Baroness is that, in terms of sexual health clinics, local authorities are mandated to commission comprehensive testing services. Clearly, however, testing needs to happen in many more areas. We have introduced testing in pharmacies, for example, for hepatitis C. That has proved very effective in identifying it in people who take drugs, as well as offering other opportunities to test particularly high-risk communities. Another example is that there has been an increased screening of the south Asian population, where there is a much higher prevalence. It is about using the opportunities of community health services and taking testing into those communities, so that we can deliver on our target.

[Lord Patel (CB)]

My Lords, direct-acting antivirals are the greatest advance that has occurred in trying to eliminate hepatitis C infection—it is effective in 95% of those who carry the infection. So a policy that does not treat everybody who is known to have the hepatitis C virus is wrong. Secondly, if we are to eliminate it, we need to identify those who carry the virus but are not diagnosed. Strategies focusing only on the prison population will not do that. Thirdly, we need to reduce the risk in the at-risk population by educating them. Unless we have a strategy across these three areas, we will not eliminate hepatitis C by 2025.

[Lord O'Shaughnessy]

I agree with the noble Lord that we need a whole-system approach, but I do not think that we necessarily need to condense that into a document. There are lots and lots of things going on, some of which I have talked about. Of course, the WHO target is about the elimination of hepatitis C as a public health risk; it is not about elimination completely. As he said, it is very difficult to find everybody who has not yet been diagnosed. The main thing is that it is reduced as a health risk: it does not kill people anymore and cannot be transmitted. That is what we are on track to do by 2025.