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Strategic plan for the elimination of hepatitis C virus in Georgia, 2016-2020

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      Globally, there are an estimated 130-150 million people living with hepatitis C virus (HCV), and more than 700,000 people die every year from HCV-associated hepatic diseases. With an HCV prevalence of 7.7% and an estimated 150,000 persons living with chronic HCV infection, Georgia has one of the highest burdens of HCV infection in the world. New cases of HCV also are on the rise, with most occurring among persons who inject drugs (PWID). HCV is a preventable and curable blood-borne infection. However, because acute infection is often asymptomatic, most persons remain unaware of their infection status until decades later, when they experience life-threatening complications (e.g., liver cancer and cirrhosis). In response to this HCV epidemic, the Government of Georgia committed to eliminating HCV in their country by 2020 (defined as 90% reduction in infection prevalence), a goal that is now achievable due to recent availability of highly effective, direct acting antivirals (DAAs) capable of curing >90% of persons treated. In addition, the country proposed the following elimination goals: a) testing 90% of HCV-infected persons for their infection; b) treating 95% of people with chronic HCV infection; and c) curing 95% of persons treated of their HCV infection.

      Georgia began laying the groundwork necessary to meet these ambitious HCV elimination goals in 2015 by establishing HCV testing and treatment sites throughout the country and treating those found to be infected with curative DAAs made available free of charge by pharmaceutical company Gilead Sciences. Furthermore, the Government of Georgia (including the Ministry of Labour, Health, and Social Affairs [MoLHSA] and the National Center for Disease Control [NCDC]) convened a Technical Advisory Group (TAG) composed of international experts in the field of viral hepatitis (e.g., representatives from the U.S. Centers for Disease Control and Prevention [CDC], World Health Organization [WHO], and other international partners). The group, which first met in November 2015, was tasked with developing strategies, objectives, and actions that would help Georgia eliminate HCV. One of TAG’s primary recommendations was development of a strategic HCV Elimination Plan accompanied by targets and indicators to promote program monitoring and evaluation.

      This Strategic Plan for the Elimination of Hepatitis C in Georgia represents the first such plan of its kind. Georgia will continue to collaborate with outside experts to implement the activities outlined in the Elimination Plan, which serves as a roadmap for other countries committed to eliminating HCV-associated morbidity and mortality and preventing new infections. The Elimination Plan will be updated as needed to accommodate advances in the field of HCV prevention and address emerging challenges.

      This work has been led by Georgia’s Ministry of Labour, Health and Social Affairs (MoLHSA) and the National Centre for Disease Control and Public Health (NCDC) in collaboration with the U.S. Centers for Disease Control and Prevention (CDC). Members of the Technical Advisory Group provided valuable time and assistance.

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      Georgia_HCV_Elimination_Strategy_2016-2020.pdf

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