NVHR supports IOM report on inadequate federal funding for chronic viral hepatitis

National Viral Hepatitis RoundtableJan 12 2010

With today's release of a landmark study by the Institute of Medicine (IOM), Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C, finding that inadequate public-health resources are being allocated to national and local prevention, control, and surveillance programs, the National Viral Hepatitis Roundtable (NVHR) today renewed its call for the Administration, Congress, and the entire health care system to take immediate and decisive action to implement the report's key recommendations. More than 5 million individuals - about 1 in 50 Americans - are afflicted with chronic viral hepatitis, most of whom are not even aware they are infected.

The NVHR is a coalition of more than 150 public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from viral hepatitis in the U.S. through strategic planning, leadership, coordination, advocacy, and research. www.nvhr.org

"On behalf of more than 5 million Americans afflicted with chronic viral hepatitis B and C, NVHR applauds the Institute of Medicine for its comprehensive examination of the complex public-health issues related to education, surveillance, immunization, and treatment of chronic viral hepatitis," said NVHR Chair Lorren Sandt. "NVHR strongly supports the IOM findings and looks forward to working with the Administration, Congress, and all stakeholders to translate the IOM's recommendations into swift and decisive action. In particular, NVHR is hopeful that the IOM will spur urgent congressional action on the bipartisan Honda-Dent legislation that would help implement many of the IOM report's recommendations. We are in the grips of a public-health crisis that cannot be ignored."

Given both the widespread prevalence of chronic viral hepatitis B and C and the IOM's finding that these diseases rank among the leading causes of preventable deaths worldwide, NVHR believes it is critical that policymakers immediately commit comprehensive resources commensurate with the depth and breadth of this crisis. For example, chronic viral hepatitis B is preventable through a vaccine, yet 78 percent of cases of primary liver cancer (HCC) and 57 percent of cases of cirrhosis are caused by chronic hepatitis B or C infection. Without swift action by the federal government, millions of American families will suffer needlessly in the coming years from chronic viral hepatitis and related complications and private and public payers will spend hundreds of billions of dollars in avoidable medical costs.

Bipartisan legislation, "The Viral Hepatitis and Liver Cancer Control and Prevention Act," was recently introduced in Congress by Representatives Mike Honda (D-Calif.) and Charles Dent (R-Pa.) that would increase federal funding for comprehensive prevention, research, and medical management referral programs for chronic viral hepatitis B and C infection. The bill would provide an initial $90 million in funding in 2011 - with additional funding thereafter - that will increase the ability of the Centers for Disease Control and Prevention (CDC) to support state health departments in their prevention, immunization and surveillance efforts. Much of the legislation tracks with the IOM's recommendations.

Left undetected and untreated, chronic hepatitis B and C can lead to cirrhosis, liver cancer, or liver failure. While African Americans and Asian Americans are disproportionately afflicted with chronic viral hepatitis infection, the diseases infect all walks of life in American society.

"The Institute of Medicine report highlights many important issues we see in our clinics," says Dr. Andrew Muir, Clinical Director of Hepatology at the Duke University School of Medicine and an NVHR Steering Committee Member. "Too many patients are unaware they have viral hepatitis, and this makes it difficult to control the spread of these infections and provide appropriate treatment to those infected. Too many patients present to our clinics in the late stages of cirrhosis or with advanced liver cancer. If we could identify these patients sooner, we have effective treatment strategies to help them avoid these devastating complications. We need coordinated surveillance and educational programs to aid us in these efforts."

Among the IOM report's key findings:

• Public-health resources are inadequate for chronic viral hepatitis prevention, control, and surveillance programs. Most chronic viral hepatitis-related activities in the CDC are administered by the Division of Viral Hepatitis (DVH), which is part of the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease, and Tuberculosis Prevention (NCHHSTP). In FY 2008, the DVH's budget allocation was $17.6 million, or 2 percent of the entire of the NCHHSTP budget. In contrast, domestic HIV activities received 69 percent of the NCHHSTP budget, sexually transmitted disease received 15 percent, and tuberculosis received 14 percent of the NCHHSTP FY 2008 budget. The DVH provides surveillance and epidemiologic studies and clinical and laboratory research; supports viral hepatitis programs at the national, state and local community levels; disseminates hepatitis related information to the public; and develops guidelines for prevention and control. NVHR believes strongly that additional funding is urgently needed to help address the chronic viral hepatitis crisis.
• As many as 1 in 50 Americans are afflicted with chronic viral hepatitis and most don't know they are infected;
• Health care and social-service providers lack knowledge and awareness about chronic viral hepatitis; and
• Chronic viral hepatitis B and C are among the leading causes of preventable deaths worldwide.