Call for urgent review of hepatitis C programme

 

Sir, – I am writing regarding the article entitled, “Ireland on the brink of eliminating hepatitis C” (October 29th) .

A letter to the editor is ideally not the place to challenge the misleading information given by Prof Aidan McCormack, clinical lead of the National Hepatitis C Treatment Programme, but I write in the hope that you may deem it appropriate to explore this important health topic further in a more balanced way.

Ireland has signed up to the World Health Organisation’s target of eliminating hepatitis C (HCV) by 2030 and I believe it more beneficial if we are to deliver on this highly ambitious target that we look to the role of the Hepatitis C National Treatment Programme, and question the lack of implementation of a national screening strategy and linkage to care programme. All of which have a key role to play in the programme’s ability to achieve elimination.

In response to concerns raised about the failure of the elimination effort to date, Prof McCormack says that the figures are “inflated” and there is “double counting” of numbers of patients in Ireland with HCV. Additionally he claims that we will achieve elimination five years ahead of schedule.

However, the Polaris Observatory group, which monitors more than 50 countries worldwide, and evaluates each country’s strategy and plans to achieve HCV elimination, states that elimination of the virus as planned by 2030 is unachievable given current treatment rates and policy in Ireland.

It predicts Ireland may not reach the goal of elimination until 2049.

Jeffery Lazarus, a leading expert in the field, conveyed a similar message at a hepatitis C meeting in Berlin in 2018, when he stated, “Ireland was first to sign up for hepatitis C elimination mandate in the EU, and will be the last to achieve it”.

The Programme Advisory Board is a group of clinical and community stakeholders set up to provide expert guidance to the National Treatment Programme in the delivery of hepatitis C treatment. Input and contribution from this group has been largely disregarded by the clinical lead and his team. I call for the dissolution of the current programme, and to have it re-structured under the governance of the Royal College of Physicians; as currently it fails to meet necessary governance requirements for an HSE programme advisory board.

An independent review ordered by the Minister of Health is urgently needed. Denial of the issues in Ireland is damaging to the vulnerable patients who are in need of engagement in care, treatment and cure of their hepatitis C infection. – Yours, etc,

Prof JOHN (JACK) LAMBERT,

Consultant in Infectious Diseases

Mater Misericordia University Hospital

Catherine McAuley Research & Education Centre,

Dublin 7