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and nationally. This will enhance the methodological calculation of impact of different interventions
and tools used to reduce rates of new infections and saving precious human life between 2016 and 2030.
These strategic parameters are aligned with plans and strategies of other relevant programs including
those for sexually transmitted infections, HIV, blood safety, safe injections, vaccines, tuberculosis and
non-communicable diseases. This integrated model will give an end to viral hepatitis and net result on
elimination of the disease.

Hepatitis C treatment
Risk of disease progression in patients living with CHC can be prevented by effective screening and
diagnostic modalities and by proper implementation of care linkage, and provision of highly effective anti
viral therapy. HCV patients with risk behaviors should be targeted and effectively engaged in the linkage
to care and should be offered sound counseling, this will help reduce further spread of infection. This is
the key element that has been stressed by different hepatology society guidelines. Engaging communities
in screening activities and linking counseling with care and treatment strategies are needed for combating
HCV epidemic. Treatment affordability as a major barrier for successful strategy is another concern apart
from other barriers.

With the advent of DAAs, cure rates exceeding 90% even with newer 8 weeks pangenotypic regimens have
been reported in large trials. Despite this astonishing success in the therapeutic armamentarium of CHC the
low and middle income countries are not able to handle the problem with success as the national strategic
plan for the elimination of Hepatitis C by 2030 for most of the countries is not developed.

Economics
A few impressive calculations determined that treating patients annually with a number exceeding 328,000
persons by 2018 could reduce the prevalence of HCV by 94% and liver-related mortality by 75% by 2030.
Calculations regarding disability-adjusted life year (DALY) with or without cirrhosis also given this therapy
high cost effectiveness, while taking into consideration the indirect costs, this intervention is again cost
[22]
saving . Requirements for meeting the WHO targets include removal of restrictions for treatment by
treating all the patients, providing access to everyone and screening at mass levels, so that 80% of infected
persons will be diagnosed by 2030 and 260,000 patients would continue to be treated per year. This
methodological approach will curtail down infections by 90% and prevent nearly a quarter million mortality
in next 13 years. While challenges have been encountered persistently in the developing world due to poor
and reliable data management mechanisms and quality of hepatitis services provided and a limited timely
intervening capacity. Apart from these, safe and necessary injection practices and disposal of waste in
effective manner are also among the major barriers.

Strong government commitment to new treatments is necessary to ensure universal coverage. According to
the European Liver Patients Association (2017), national plans must be developed and include forecasting
and budgeting to expedite unrestricted access to treatment, in order to succeed in eliminating HCV.

Global strive towards elimination of HCV
After WHO’s 2030 elimination goal was laid down in 2015, till now only 9 countries are on the track of
achieving this goal. While 22 countries are working towards the direction of achieving on-track policies, the
[11]
rest of the world is still far behind the laid down parameters .

A glimpse of global policy making; European and Australia: Universal access to DAAs
Only a few of the countries reviewed, have granted universal coverage for DAAs. Australia, Portugal,
Germany, and since 2017, France and Italy, offer access to DAAs for all patients, regardless of their level of
fibrosis. Scotland and England do not have fibrosis requirements, but have limits on numbers of patients