McGill University Department of Epidemiology, Biostatistics, and Occupational Health, Montreal, Quebec, Canada.
Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.
PLoS One. 2020 Jul 28;15(7):e0235715. doi: 10.1371/journal.pone.0235715. eCollection 2020.
New hepatitis C virus (HCV) treatments spurred the World Health Organization (WHO) in 2016 to adopt a strategy to eliminate HCV as a public health threat by 2030. To achieve this, key policies must be implemented. In the absence of monitoring mechanisms, this study aims to assess the extent of policy implementation from the perspective of liver patient groups.
Thirty liver patient organisations, each representing a country, were surveyed in October 2018 to assess implementation of HCV policies in practice. Respondents received two sets of questions based on: 1) WHO recommendations; and 2) validated data sources verifying an existing policy in their country. Academic experts selected key variables from each set for inclusion into policy scores. The similarity scores were calculated for each set with a multiple joint correspondence analysis. Proxy reference countries were included as the baseline to contextualize results. We extracted scores for each country and standardized them from 0 to 10 (best).
Twenty-five countries responded. For the score based on WHO recommendations, Bulgaria had the lowest score whereas five countries (Cyprus, Netherlands, Portugal, Slovenia, and Sweden) had the highest scores. For the verified policy score, a two-dimensional solution was identified; first dimension scores pertained to whether verified policies were in place and second dimension scores pertained to the proportion of verified policies in-place that were implemented. Spain, UK, and Sweden had high scores for both dimensions.
Patient groups reported that the European region is not on track to meet WHO 2030 HCV goals. More action should be taken to implement and monitor HCV policies.
新的丙型肝炎病毒（HCV）治疗方法促使世界卫生组织（WHO）于 2016 年通过了一项战略，旨在到 2030 年消除 HCV 对公共卫生的威胁。为了实现这一目标，必须实施关键政策。由于缺乏监测机制，本研究旨在从肝病患者群体的角度评估政策实施的程度。
2018 年 10 月对 30 个肝脏患者组织进行了调查，以评估 HCV 政策在实践中的实施情况。根据以下两种情况向受访者提出了两组问题：1）世卫组织的建议；2）验证其国家现有政策的有效数据源。学术专家从每套问题中选择关键变量，纳入政策评分。对两套问题进行相似性评分，并采用多元联合对应分析进行计算。将代理参考国家作为基准纳入，以对结果进行背景化处理。我们为每个国家提取了分数，并将其从 0 到 10（最佳）进行标准化。
有 25 个国家作出回应。根据世卫组织的建议，保加利亚的得分最低，而塞浦路斯、荷兰、葡萄牙、斯洛文尼亚和瑞典五个国家的得分最高。对于验证政策得分，确定了二维解决方案；第一维分数涉及是否实施了验证政策，第二维分数涉及实施的验证政策中实施的比例。西班牙、英国和瑞典在两个维度上的得分都很高。
患者群体报告称，欧洲地区尚未达到世卫组织 2030 年 HCV 目标。应采取更多行动来实施和监测 HCV 政策。
