推動消除C肝政策之回顧

Implementation of hepatitis C policies in Taiwan

為滿足我國C肝防治需求及呼應世界衛生組織消除C肝的目標，衛生福利部於2016年12月成立「國家C型肝炎旗艦計畫辦公室」，並於2019年12月更名為「國家消除C肝辦公室」，以展現政府決心及消除C肝之承諾。為能更有效地溝通及協調相關政策，辦公室蒐集全國的C肝流行病學概況及臨床特徵等實證資料，並在肝病、流病、經濟專家、公衛官員及署司首長的指導下，在2019年5月公布「國家消除C肝政策綱領2018-2025」。綱領設立2025年消除C肝之願景，錨定三大核心策略、三大政策方向及八大行動方針，讓各界理解政府的施政目標及方向，以利各界辦理消除C肝活動時能有依循。本文旨在彙整這幾年來中央與地方政府結合民間資源，在公私協力下的作為與進展，包括確保充足的預算；降低C肝防治障礙，提高服務可近性，落實防治一條龍；落實精準篩檢及診治策略；推動高風險族群C肝防治；加強C肝識能；政策成效評估；鼓勵研究發展與引進有效之篩檢診斷工具等面向。

The Taiwan National Hepatitis C Program Office has been established since December 2016 by the Ministry of Health and Welfare of Taiwan, to respond to the society’s calling for a national policy on hepatitis C control, as well as being the first step toward the WHO’s goal set on 2015. Aimed to more effective on communicating and coordinating related policies, the Office gathered information about epidemiological profile and clinical characteristics of hepatitis C nationwide and, with the advice and guidance provided by experts from hepatologists, epidemiologists, economists, public health officers, and government leaders, the “Taiwan Hepatitis C Policy Guideline 2018-2025” was formulated and announced in May 2019. The Guideline set up a goal of hepatitis C elimination by 2025 and highlighted three policy directions, three core strategies, eight action plans that could be implemented by relevant stakeholders at all levels of governments and across public and private sectors. This article aims to summarize the activities which have been implemented as of to date - from the central and local governments, or public and private sectors. These activities include securing adequate budget; lowering barriers of access to care; maintaining continuum of care to leave no one behind; implementing precision screening and diagnosis and treatment strategies; promoting the interventions and strategies among high-risk groups; raising the public awareness on HCV screening and treatment; evaluating outcomes of policy and interventions; encouraging R&D and the introduction of HCV screening and in vitro diagnostic kits products as well.