[10 years of the Strategic Plan for Tackling Hepatitis C in the Spanish National Health System (PEAHC): A national project for the elimination of Hepatitis C as a Public Health problem].

Abstract

The tenth anniversary of the Strategic Plan for Addressing Hepatitis C in the National Health System (PEAHC) is a milestone in Spanish healthcare, consolidating the country as a global leader in the fight against this disease. In these ten years it has been demonstrated that a well-structured strategy can transform a health crisis into an opportunity, reducing the prevalence of active hepatitis C virus (HCV) infection in the general population from 1.2% (95% CI: 0.3%-1.8%) in 2014 to 0.12% (95% CI: 0.03-0.24) in 2022, achieving a cure rate greater than 94% in the more than 172,000 patients treated with direct-acting antivirals until 2024, a marked and sustained improvement in all morbidity and mortality indicators in the last decade such as the reduction from 32% in 2015 to 7% in 2024 of patients with HCV on the waiting list for liver transplant. Reductions in active HCV infection among people living with the human immunodeficiency virus, people who inject drugs (PID), and people in the prison setting have been spectacular. Key factors ensuring success have been political commitment and sustainable funding, integrated Public Health strategies for the primary prevention of new HCV cases (improvements in health care safety, transfusion safety, risk and harm reduction programs for PID), a universal public health system that ensures equitable access to treatment, decentralized tasks and, finally, interinstitutional coordination.