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Evaluation of the Hepatitis C Prevention, Support and Research Program 1999/2000 – 2005/2006

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7. Recommendations for Future Initiatives to Address Hepatitis C

The Program has made significant strides in its efforts to address the hepatitis C epidemic and has an impressive record of achievements on which to build in the future. Recommended directions include:

Recommendation 1:

To stabilize, sustain, build on and increase the capacity and initiatives generated through the Hepatitis C Prevention, Support and Research Program to date, and given that hepatitis C infection is still a significant problem, PHAC should develop a national plan with national goals and priorities for dealing with HCV. This would require securing long term stable/sustainable funding for HCV based on trends in the disease, evidence (surveillance and epidemiological research) and economic burden of illness/cost benefit analysis in order to address shifting risk conditions and contexts including those most vulnerable to infection.

Recommendation 2:

Developing mechanisms for partnerships with F/P/Territorial Ministries of Health, Solicitors General, Social Services, Mental Health, First Nations and Inuit Health Branch, and Correctional Services Canada; and

Supporting collaboration between related issues (sexual health) and strategies, e.g., Canada's Drug Strategy and the Federal Initiative to Address HIV/AIDS in Canada.

This would transcend programmatic, jurisdictional and disease-specific boundaries and leverage scarce resources, promote a coordinated domestic approach as well as a global understanding of infectious diseases, by linking hepatitis C (B and related infectious diseases) with other levels of government, community organizations and key stakeholders. Conceptually, the approach would resemble a ‘mosaic’ where each disease, program and jurisdiction would work in a coordinated manner while maintaining a distinct role and ‘voice'.

Recommendation 3:

To build on the research capacity already established, PHAC should continue to provide funding for interdisciplinary research in partnership with the Canadian Institutes for Health Research and other key funding partners. Emphasis should be placed on improving communication of research knowledge among all stakeholders.

Recommendation 4:

To support current Enhanced Hepatitis Strain Surveillance System activities, surveillance should continue as a prominent component of future hepatitis C programming:

  • Surveillance activities, information management and standard databases for infectious diseases should be coordinated across all levels of government, i.e., federal, provincial, territorial; and
  • Surveillance, research and evaluation activities should be linked and used as inputs to informed decision-making, timely policy formulation and shifts in programmatic priorities and approaches.

Recommendation 5:

Continued emphasis on increasing public awareness of HCV is critical in order to encourage testing, bring people into care and to provide support and a possible cure. Research findings have indicated that a person who becomes aware of his/her HCV infection is able to seek treatment and care, slow their own disease progression, and prevent the transmission of their own infection to others. This will decrease both the prevalence of HCV in Canada and future costs to health care systems.

Recommendation 6:

Currently, an estimated one-third of all hepatitis C cases are undiagnosed and a larger group is not aware of the risks. To help address this situation and build on what has already been established, continue promoting awareness of hepatitis C issues nationally, in rural and remote communities, and among vulnerable populations. Part of this is a ‘listening’ role to a ‘voice’ of the people (those most at risk, were/are dispersed, heterogeneous without large national organization representation) who did not have strong voices. Ensure a coordinated approach that is evidence-based and that articulates and is responsive to the needs of those most at risk & inclusive of those living with HCV as well as those providing care and support in order to ensure effective initiatives.

Summation

Given the significant achievements made in addressing HCV in Canada, as well as the need for ongoing vigilance, the federal government should continue the momentum of the past seven years by renewing its commitment for a sustained public health response to address hepatitis C and related infectious diseases.

8. List of Acronyms

AIDS
Acquired Immunodeficiency Syndrome
CAID
Community Acquired Infections Division
CIDPC
Centre for Infectious Disease and Prevention Control
CIHR
Canadian Institutes of Health Research
CSC
Correctional Services Canada
EPAG
Expanded Program Advisory Group
EHSSS
Enhanced Hepatitis Strain Surveillance System
Epi
Epidemiology
FNIHB
First Nations and Inuit Health Branch
FTE
Full-time equivalent
F/P/T
Federal / Provincial / Territorial
G&C
Grants and Contributions
HBV
Hepatitis B Virus
HC
Health Canada
HCV
Hepatitis C Virus
HCV+
Hepatitis C positive
HIV
Human Immunodeficiency Virus
IDU
Injection Drug Use or User
JAC
Joint Advisory Committee
LCDC
Laboratory Centre for Disease Control
NCR
National Capital Region
NCRTP
National Canadian Research Training Program
NGO
Non–government Organization
NNDRS
National Notifiable Disease Reporting System
O&M
Operating and maintenance
PAA
Program Activity Architecture
PAG
Program Advisory Group
PHAC
Public Health Agency of Canada
PPHB
Population and Public Health Branch
P/T
Provincial / Territorial
RBAF
Risk-Based Audit Framework
RMAF
Results-Based Management and Accountability Framework
STI
Sexually transmitted infection
TB
Tuberculosis
YPC
Youth Planning Committee


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