Browsing by Author "Lazarus, Jeffrey V."
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- Beyond viral suppression of HIV - the new quality of life frontierPublication . Lazarus, Jeffrey V.; Safreed-Harmon, Kelly; Barton, Simon E.; Costagliola, Dominique; Dedes, Nikos; Valero, Julia del Amo; Gatell, Jose M.; Baptista-Leite, Ricardo; Mendão, Luís; Porter, Kholoud; Vella, Stefano; Rockstroh, Jürgen KurtBackground: In 2016, the World Health Organization (WHO) adopted a new Global Health Sector Strategy on HIV for 2016-2021. It establishes 15 ambitious targets, including the '90-90-90' target calling on health systems to reduce under-diagnosis of HIV, treat a greater number of those diagnosed, and ensure that those being treated achieve viral suppression. Discussion: The WHO strategy calls for person-centered chronic care for people living with HIV (PLHIV), implicitly acknowledging that viral suppression is not the ultimate goal of treatment. However, it stops short of providing an explicit target for health-related quality of life. It thus fails to take into account the needs of PLHIV who have achieved viral suppression but still must contend with other intense challenges such as serious non-communicable diseases, depression, anxiety, financial stress, and experiences of or apprehension about HIV-related discrimination. We propose adding a 'fourth 90' to the testing and treatment target: ensure that 90 % of people with viral load suppression have good health-related quality of life. The new target would expand the continuum-of-services paradigm beyond the existing endpoint of viral suppression. Good health-related quality of life for PLHIV entails attention to two domains: comorbidities and self-perceived quality of life. Conclusions: Health systems everywhere need to become more integrated and more people-centered to successfully meet the needs of virally suppressed PLHIV. By doing so, these systems can better meet the needs of all of their constituents - regardless of HIV status - in an era when many populations worldwide are living much longer with multiple comorbidities.
- Innovative strategies for the elimination of viral hepatitis at a national level: a country case seriesPublication . Schröeder, Sophia E.; Pedrana, Alisa; Scott, Nick; Wilson, David; Kuschel, Christian; Aufegger, Lisa; Atun, Rifat; Baptista-Leite, Ricardo; Butsashvili, Maia; El-Sayed, Manal; Getahun, Aneley; Hamid, Saeed; Hammad, Radi; Hoen, Ellen ‘t; Hutchinson, Sharon J.; Lazarus, Jeffrey V.; Lesi, Olufunmilayo; Li, Wangsheng; Mohamed, Rosmawati Binti; Olafsson, Sigurdur; Peck, Raquel; Sohn, Annette H.; Sonderup, Mark; Spearman, Catherine W.; Swan, Tracy; Thursz, Mark; Walker, Tim; Hellard, Margaret; Howell, JessicaViral hepatitis is a leading cause of morbidity and mortality worldwide, but has long been neglected by national and international policymakers. Recent modelling studies suggest that investing in the global elimination of viral hepatitis is feasible and cost-effective. In 2016, all 194 member states of the World Health Organization endorsed the goal to eliminate viral hepatitis as a public health threat by 2030, but complex systemic and social realities hamper implementation efforts. This paper presents eight case studies from a diverse range of countries that have invested in responses to viral hepatitis and adopted innovative approaches to tackle their respective epidemics. Based on an investment framework developed to build a global investment case for the elimination of viral hepatitis by 2030, national activities and key enablers are highlighted that showcase the feasibility and impact of concerted hepatitis responses across a range of settings, with different levels of available resources and infrastructural development. These case studies demonstrate the utility of taking a multipronged, public health approach to: (a) evidence-gathering and planning; (b) implementation; and (c) integration of viral hepatitis services into the Agenda for Sustainable Development. They provide models for planning, investment and implementation strategies for other countries facing similar challenges and resource constraints.
- A multinational Delphi consensus to end the COVID-19 public health threatPublication . COVID-19 Consensus Statement Panel; Lazarus, Jeffrey V.; Romero, Diana; Kopka, Christopher J.; Karim, Salim Abdool; Abu-Raddad, Laith J.; Almeida, Gisele; Baptista-Leite, Ricardo; Barocas, Joshua A.; Barreto, Mauricio L.; Bar-Yam, Yaneer; Bassat, Quique; Batista, Carolina; Bazilian, Morgan; Chiou, Shu Ti; Del Rio, Carlos; Dore, Gregory J.; Gao, George F.; Gostin, Lawrence O.; Hellard, Margaret; Jimenez, Jose L.; Kang, Gagandeep; Lee, Nancy; Matičič, Mojca; McKee, Martin; Nsanzimana, Sabin; Oliu-Barton, Miquel; Pradelski, Bary; Pyzik, Oksana; Rabin, Kenneth; Raina, Sunil; Rashid, Sabina Faiz; Rathe, Magdalena; Saenz, Rocio; Singh, Sudhvir; Trock-Hempler, Malene; Villapol, Sonia; Yap, Peiling; Binagwaho, Agnes; Kamarulzaman, Adeeba; El-Mohandes, AymanDespite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
- Pathways to ensure universal and affordable access to hepatitis C treatmentPublication . Douglass, Caitlin H.; Pedrana, Alisa; Lazarus, Jeffrey V.; Hoen'T, Ellen F. M.; Hammad, Radi; Leite, Ricardo Baptista; Hill, Andrew; Hellard, MargaretDirect-acting antivirals (DAAs) have dramatically changed the landscape of hepatitis C treatment and prevention. The World Health Organization has called for the elimination of hepatitis C as a public health threat by 2030. However, the discrepancy in DAA prices across low-, middle- and high-income countries is considerable, ranging from less than US 100 to approximately US 40,000 per course, thus representing a major barrier for the scale-up of treatment and elimination. This article describes DAA pricing and pathways to accessing affordable treatment, providing case studies from Australia, Egypt and Portugal. Pathways to accessing DAAs include developing comprehensive viral hepatitis plans to facilitate price negotiations, voluntary and compulsory licenses, patent opposition, joint procurement, and personal importation schemes. While multiple factors influence the price of DAAs, a key driver is a country's capacity and willingness to negotiate with pharmaceutical companies. If negotiations do not lead to a reasonable price, governments have the option to utilise flexibilities outlined in the Agreement on Trade-Related Aspects of Intellectual Property Rights. Affordable access to DAAs is underpinned by collaboration between government, civil society, global organisations and pharmaceutical companies to ensure that all patients can access treatment. Promoting these pathways is critical for influencing policy, improving access to affordable DAAs and achieving hepatitis C elimination.
- Securing wider EU commitment to the elimination of hepatitis C virusPublication . Wedemeyer, Heiner; Tergast, Tammo L.; Lazarus, Jeffrey V.; Razavi, Homie; Bakoyannis, Kostas; Baptista-Leite, Ricardo; Bartoli, Marco; Bruggmann, Philip; Buşoi, Cristian Silviu; Buti, Maria; Carballo, Manuel; Castera, Laurent; Colombo, Massimo; Coutinho, Rodrigo Sousa; Dadon, Yuval; Esmat, Gamal; Esteban, Rafael; Farran, Joan Colom; Gillyon-Powell, Mark; Goldberg, David; Hutchinson, Sharon; Janssen, Harry L.A.; Kalamitsis, George; Kondili, Loreta A.; Lambert, John S.; Marinho, Rui Tato; Maticic, Mojca; Patricello, Aldo; Peck-Radosavljevic, Markus; Pol, Stanislas; Poljak, Mario; Pop, Cora; Sokol, Tomislov; Sypsa, Vana; Tözün, Nurdan; Younossi, Zobair; Aghemo, Alessio; Papatheodoridis, George V.; Hatzakis, AngelosIn 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto, calling for the elimination of HCV in the EU by 2030. Since then, many European countries have made progress towards HCV elimination. Multiple programmes—from the municipality level to the EU level—were launched, resulting in an overall decrease in viremic HCV infections and liver-related mortality. However, as of 2021, most countries are not on track to reach the 2030 HCV elimination targets set by the WHO. Moreover, the COVID-19 pandemic has resulted in a decrease in HCV diagnoses and fewer direct-acting antiviral treatment initiations in 2020. Diagnostic and therapeutic tools to easily diagnose and treat chronic HCV infection are now well established. Treating all patients with chronic HCV infection is more cost-saving than treating and caring for patients with liver-related complications, decompensated cirrhosis or hepatocellular carcinoma. It is more important than ever to reinforce and scale-up action towards HCV elimination. Yet, efforts urgently need the dedicated commitment of policymakers at all governmental and policy levels. Therefore, the third EU Policy Summit, held in March 2021, featured EU parliamentarians and other key decision makers to promote dialogue and take strides towards securing wider EU commitment to advance and achieve HCV elimination by 2030. We have summarized the key action points and reported the ‘Call-to-Action’ statement supported by all the major relevant European associations in the field.