Thursday, November 21, 2024
11/21/2024
Project Abstract Viral Hepatitis has been historically underfunded in Alabama (AL), appropriate funding has been highly anticipated for at least 15 years. AL ranks poorly in several health indicators and has been plagued by ongoing hepatitis A (HAV) outbreak as well as rates of hepatitis B (HBV) well matched to national averages, despite a low proportion of Asian population. Furthermore, funds are extremely needed due to the high rates of incarceration in the state, high rates of transmission in our prisons, health disparities, lack of Medicaid expansion, persistence of hepatitis C Direct Acting Antivirals (DAA) restrictions, and lack of Syringe Services Programs (SSPs) all contributing to threatened efforts to keep AL on track to eliminate hepatitis C (HCV) by 2030. Despite all these challenges, ADPH is in pursuit to build state-wide capacity for surveillance, prevention and care programs. ADPH will leverage formative work done with key collaborators, including Center for Disease Analysis Foundation (CDAF), universities, Corrections and Opioid Response Council. Our plan will build the necessary infrastructure and improve delivery of services for viral hepatitis. In collaboration with CDAF and stakeholders in the state, Alabama has already begun development of an elimination model for hepatitis C. Using the World Health Organization (WHO) Elimination Targets (defined by the WHO as a 90% diagnosis and 80% treatment of all infections, an 80% reduction in incident cases and a 65% reduction in liver-related mortality by 2030), we assessed elimination targets that can be achieved in Alabama by taking at least one approach [1]. At the beginning of 2018, Alabama had 45,100 HCV-RNA+ (viremic) infections accounting for 0.91% of the population in Alabama. Approximately 64% of infections were diagnosed previously (n=29,000), with 1,170 infections newly diagnosed, and 4% of persons infected were initiated on treatment (n=1,720) in 2018. There were an estimated 1,360 new infections and diagnoses, corresponding to an incidence rate of 27 per 100,000 in 2018: • 57% of total infections were in the 1945 to 1965 birth cohort* • 10% of total infections were among women of childbearing age* • 7% of total infections were among people who inject drugs* • 4% of total infections were among the incarcerated population* • 20% of infections were among diagnosed patients on Medicaid* *Percentages do not sum to 100% because overlap exists across groups and not all subpopulations are considered here [1]. By the end of year one, ADPH intends to: have a fully staffed program; identify the highest volume of clinical laboratories that report 80% or more of HCV antibody tests and tests for HBV in the jurisdiction, conduct a needs assessment for the identified high-volume health systems, and provide solutions needed to increase routine HBV and HCV testing.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
