Quality assurance of Hepatitis B and C care provision in the EU – the Euro Hepatitis Care Index

In European healthcare, with generally good tracking of epidemics, viral hepatitis is a neglected threat, although an estimated 23 million people live with chronic hepatitis. Even in countries with high disease awareness and active prevention policies, less than 40 % of the infections are detected. This means that even in well-organised countries such as UK and Germany, less than one out of five infected people know they carry the infection! In most other countries the detection rate is dramatically lower, which is why in parts of the EU still not even a single case out of one hundred people carrying the virus are diagnosed! This means that millions of Europeans are still unaware of their hepatitis.

A general, rather upsetting impression from this first ever comparison of hepatitis care performance around Europe is that effective action on hepatitis is not seen as a high priority by governments. Not only are the detection rates low or even almost non-existent; identified chronic hepatitis is often left untreated, with less than 20% of the patients receiving treatment. That explains why every year no less than 125 000 Europeans die from various hepatitis-related diseases such as liver cancer, liver cirrhosis, blood infection or HIV.

The lack of political focus may be explained by the “class stigma” of hepatitis diseases. High-risk groups for acquiring and spreading the disease are injection drug users, children of infected mothers, professional sex workers, prison inmates, migrant populations and men having sex with men. These people have little political clout. Policy makers should be aware that among the risk groups are healthcare staff as well as patients on blood dialysis. Lack of political awareness and focus eventually puts the general population at risk.

The Euro Hepatitis Index makes a comprehensive diagnosis of 30 European countries with regard to the capacity to handle the hepatitis threat. The Index not only provides a cross-Europe description of problems and opportunities but also offers an analysis of each country, with a recipe for forming a national hepatitis agenda. Thus the Index can be seen, and hopefully used, as a checklist for repairing and improving the conditions for millions of people in Europe. Implementation of a pan-European best practice would be essential. The EU has the authority to address this issue – but maybe practical life-saving cannot compete with the many rivaling attractions on the steadily expanding EU pallet?

The Health Consumer Powerhouse gratefully acknowledges the financial support from ELPA (European Liver Patient Association) making possible this piece of reality research and the co-operation with EASL (European Association for Study of the Liver).

Brussels, November 6, 2012
Johan Hjertqvist
Founder & President
Health Consumer Powerhouse