January 12, 2022


Josh Berkowitz: (703) 939-7056

WASHINGTON, D.C. (January 12, 2022) — The O’Neill Institute for National and Global Health Law at Georgetown University Law Center (O’Neill Institute), the National Viral Hepatitis Roundtable (NVHR), and the Center for Health Law and Policy Innovation at Harvard Law School (CHLPI) launched Hep ElimiNATION, a partnership to study viral hepatitis elimination efforts across the United States. Hep ElimiNATION is the country’s first comprehensive analysis of the policy landscape and programmatic strategies aimed at viral hepatitis elimination in the 50 states, Washington, DC, and Puerto Rico.

Hep ElimiNATION assigns a letter grade to all 52 jurisdictions based on elements of their current capacity to eliminate viral hepatitis by 2030 and in alignment with the HHS Viral Hepatitis National Strategic Plan, including:

  • State viral hepatitis elimination plan development;
  • Harm reduction laws and policies;
  • Budget allocations;
  • Improving viral hepatitis prevention, treatment and outcomes;
  • Reducing viral hepatitis-related disparities and health inequities;
  • Improving viral hepatitis surveillance and data usage; and
  • Achieving integrated, coordinated efforts that address the viral hepatitis epidemics among all partners and stakeholders.

“Hep ElimiNATION is built on the important understanding that eliminating viral hepatitis by 2030, an ambitious goal set by the World Health Organization, requires a collective effort by federal and state policymakers, public health agencies, advocacy partners, community-based organizations, and those with lived experience,” said Sonia Canzater, JD, MPH, Associate Director at the O’Neill Institute. “Thanks to the work of our public health servants, including the viral hepatitis coordinators across the country working on prevention strategies, much work is already being done to make hepatitis elimination a reality. With an even greater look at the gaps and opportunity areas in each state’s viral hepatitis elimination capacity, Hep ElimiNATION can further guide policy and programmatic decisions to bring an end to viral hepatitis, a condition that impacts millions of Americans every day.”

Over 5 million Americans today are living with chronic hepatitis B and/or chronic hepatitis C, which can cause severe liver disease, liver cancer, and death. Tools to prevent, test for, and treat viral hepatitis exist, including vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV), and highly effective treatment for hepatitis C virus (HCV). Yet the United States is losing ground on the fight against viral hepatitis overall. New infections have spiked due to the ongoing opioid overdose epidemic; only 25% of adults are currently vaccinated against HBV; and treatment levels for hepatitis C have disturbingly declined between 2014 and 2020, according to recently published data from the Centers for Disease Control and Prevention (CDC). Viral hepatitis disproportionately impacts communities of color, people who use drugs, immigrants, people who are incarcerated, and others who have historically faced inequities in access to healthcare.

Based on a grading scale developed in consultation with more than 40 stakeholders, including advocates, clinicians, government partners, and people who have lived experience with viral hepatitis, Hep ElimiNATION is an advocacy tool to bring awareness to policymakers, public health agencies, and communities about a broad range of key considerations for elimination.

“Centering the voices of people with lived experience is critical to addressing the barriers that so many face in access to prevention, testing, and treatment for viral hepatitis,” said Adrienne Simmons, PharmD, MS, Director of Programs at NVHR. “Hep ElimiNATION will allow those with lived experience and other advocates to gain a better understanding of their state’s current capacity to eliminate viral hepatitis, and follow up with actionable recommendations and strategies to develop comprehensive and fully-funded elimination plans.”

“Viral hepatitis elimination requires investment in harm reduction strategies that lead to better outcomes for the most vulnerable populations, including people who inject drugs (PWID), who currently make up 80% of new HCV infections,” said Daniel Raymond, Director of Policy at NVHR. “Hep ElimiNATION recognizes the importance of harm reduction in elimination, and looks at jurisdictions’ capacity to screen, treat, and provide linkage to care for this community’s needs. We cannot end the hepatitis epidemic without providing full attention to the needs of PWID.”

Several states have published elimination plans since the beginning of 2019 to address critical issues that impact a state’s ability to tackle viral hepatitis, including legality of syringe service programs; budget allocations specifically marked for viral hepatitis elimination; training and educational programs; access to treatment for state Medicaid beneficiaries; and attention to disparities and health inequities, among other important pieces.

Beyond comprehensive elimination plans, jurisdictions across the country are increasing their efforts to eliminate barriers to treatment access, particularly for Medicaid recipients who are disproportionately impacted by the viral hepatitis epidemic. States are removing burdensome barriers to treatment, including restrictions based on liver damage, sobriety, and provider requirements. As of January 2022, eleven states have eliminated prior authorizations for hepatitis C treatment entirely.

“We are glad to see that an increasing number of jurisdictions are removing significant barriers to hepatitis C treatment access for their most vulnerable populations,” said Robert Greenwald, JD, Faculty Director of CHLPI. “Incorporating the findings of the Hepatitis C: State of Medicaid Access project, which evaluates treatment access in each state’s Medicaid program, Hep ElimiNATION takes into consideration the needs of Medicaid recipients and those who have long been subject to health inequity – a necessary consideration to achieve viral hepatitis elimination.”

Following the initial grade release, there will be a 90-day comment period when the public can submit requests for amendment, and any score modifications resulting from the comment period will be reflected in an update scheduled for June 2022. The scoring rubric for Hep ElimiNATION will be evaluated annually to ensure that it is responsive to the evolving elimination landscape and reflects the most current strategic needs. State scores will also be updated annually, and Hep ElimiNATION will continually monitor nationwide elimination efforts.


About the O’Neill Institute for National and Global Health Law at Georgetown University Law Center (O’Neill Institute)

The O’Neill Institute, housed at Georgetown University Law Center, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. Read more at www.oneillinstitute.org.

About the National Viral Hepatitis Roundtable (NVHR)

The National Viral Hepatitis Roundtable, an initiative of HEP, is a national coalition fighting for an equitable world free of viral hepatitis. NVHR seeks to eliminate viral hepatitis in the United States and improve the lives of those affected through advocacy, education, and support to national, state and local partners. For more information, visit www.nvhr.org.

About the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI)

The Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) advocates for legal, regulatory, and policy reforms to improve the health of underserved populations, with a focus on the needs of low-income people living with chronic illnesses and disabilities. CHLPI works with consumers, advocates, community-based organizations, health and social services professionals, government officials, and others to expand access to high-quality health care; to reduce health disparities; to develop community advocacy capacity; and to promote more equitable and effective health care systems. CHLPI is a clinical teaching program of Harvard Law School and mentors students to become skilled, innovative, and thoughtful practitioners as well as leaders in health and public health law and policy. For more information, visit http://www.chlpi.org.