Hepatitis C is not a visible virus. It disproportionately affects disadvantaged and marginalised communities, with almost half of people who attend hospital for hepatitis C coming from the poorest fifth of society. People living with hepatitis C often experience few obvious symptoms, and 40-50% of the estimated 160,000 with hepatitis C in England are unaware they are infected, though the virus can lead to fatal liver cirrhosis and cancer. Those most at risk of transmission from blood-to-blood contact are already from marginalised groups less likely to have a strong voice, including people who inject drugs, men who have sex with men, and migrant communities from endemic countries. When compared to HIV, also a blood-borne virus with similar transmission routes, awareness of hepatitis C is exponentially lower.
Life for those diagnosed has not been easy. Until recently, the only treatment option was an injection-based treatment lasting up to a year, with significant side effects and only a 50% chance of getting cured. In 2015, miraculous new treatments curing over 95% of people became available, with much shorter treatment durations and few, if any, side effects. This was an outstanding scientific achievement, but waiting lists for treatment prevented some from accessing a cure for long periods, and caused many others to drop out of care.
All of this is about to become a relic of the past. We now have an extraordinary opportunity to eliminate hepatitis C, with treatments set to become universally available following a new funding agreement between NHS England and industry due to be agreed later this year. Urgent national action is needed to find, diagnose, and treat everyone living with hepatitis C. Today, a new report by a cross-party group of MPs and peers sets out the road to elimination in the exceptional context of this deadly virus now being fully curable with easily deliverable, highly cost-effective medicines.
This opportunity comes with new challenges. As waiting lists for treatment decline and most historically infected patients who were already diagnosed and in touch with health services have now been treated, it must be a national ambition to find the undiagnosed, and re-engage those previously diagnosed who have never been treated. Leaving vulnerable people out there to develop life-threatening cirrhosis and liver cancer when we have a full cure available is a serious public health failure.