Cooke Graham S, Flower Barnaby, Cunningham Evan, Marshall Alison D, Lazarus Jeffrey V, Palayew Adam, Jia Jidong, Aggarwal Rakesh, Al-Mahtab Mamum, Tanaka Yashuito, Jeong Sook-Hyang, Poovorawan Kittiyod, Waked Imam, Hiebert Lindsey, Khue Pham M, Grebely Jason, Alcantara-Payawal Diana, Sanchez-Avila Juan F, Mbendi Charles, Muljono David H, Lesi Olufunmilayo, Desalegn Hailemichael, Hamid Saeed, de Araujo Alexandre, Cheinquer Hugo, Onyekwere Charles A, Malyuta Ruslan, Ivanchuk Iryna, Thomas David L, Pimenov Nikolay, Chulanov Vladimir, Dirac Mae Ashworth, Han Hannah, Ward John W
Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK; Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.
Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK.
Lancet Gastroenterol Hepatol. 2024 Apr;9(4):346-365. doi: 10.1016/S2468-1253(23)00321-7. Epub 2024 Feb 15.
The top 20 highest burdened countries (in disability-adjusted life years) account for more than 75% of the global burden of viral hepatitis. An effective response in these 20 countries is crucial if global elimination targets are to be achieved. In this update of the Lancet Gastroenterology & Hepatology Commission on accelerating the elimination of viral hepatitis, we convene national experts from each of the top 20 highest burdened countries to provide an update on progress. Although the global burden of diseases is falling, progress towards elimination varies greatly by country. By use of a hepatitis elimination policy index conceived as part of the 2019 Commission, we measure countries' progress towards elimination. Progress in elimination policy has been made in 14 of 20 countries with the highest burden since 2018, with the most substantial gains observed in Bangladesh, India, Indonesia, Japan, and Russia. Most improvements are attributable to the publication of formalised national action plans for the elimination of viral hepatitis, provision of publicly funded screening programmes, and government subsidisation of antiviral treatments. Key themes that emerged from discussion between national commissioners from the highest burdened countries build on the original recommendations to accelerate the global elimination of viral hepatitis. These themes include the need for simplified models of care, improved access to appropriate diagnostics, financing initiatives, and rapid implementation of lessons from the COVID-19 pandemic.
负担最重的20个国家（按伤残调整生命年计算）占全球病毒性肝炎负担的75%以上。如果要实现全球消除目标，这20个国家的有效应对至关重要。在《柳叶刀·胃肠病学和肝脏病学》关于加速消除病毒性肝炎委员会的本次更新中，我们召集了负担最重的20个国家中的各国专家，以提供进展情况的最新信息。尽管全球疾病负担正在下降，但各国在消除方面的进展差异很大。通过使用作为2019年委员会一部分构想的肝炎消除政策指数，我们衡量各国在消除方面的进展。自2018年以来，20个负担最重的国家中有14个在消除政策方面取得了进展，在孟加拉国、印度、印度尼西亚、日本和俄罗斯观察到了最大的进展。大多数改进归因于消除病毒性肝炎的正式国家行动计划的发布、公共资助筛查计划的提供以及政府对抗病毒治疗的补贴。负担最重国家的国家专员之间的讨论中出现的关键主题基于最初的建议，以加速全球消除病毒性肝炎。这些主题包括需要简化护理模式、改善获得适当诊断的机会、融资举措以及迅速实施从COVID-19大流行中吸取的经验教训。
