{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T04:27:47Z","timestamp":1790483267214,"version":"4.1.0"},"reference-count":63,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2016,1,26]],"date-time":"2016-01-26T00:00:00Z","timestamp":1453766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>In the <jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">EURO<\/jats:styled-content> region, around 28 million people are currently living with chronic viral hepatitis, and 120\u00a0000 people die every year because of it. Lack of awareness and understanding combined with the social stigma and discrimination exacerbate barriers related to access to prevention, diagnosis and treatment services for those most in need. In addition, the persisting economic crisis has impacted on public health spending, thus posing challenges on the sustainable investment in promotion, primary and secondary prevention, diagnosis and treatment of viral hepatitis across European countries. The Hepatitis B and C Public Policy Association in cooperation with the Hellenic Center for Disease Prevention and Control together with 10 partner organizations discussed at the Athens High Level Meeting held in June 2014 recent policy developments, persisting and emerging challenges related to the prevention and management of viral hepatitis and the need for a <jats:italic>de minimis<\/jats:italic> framework of urgent priorities for action, reflected in a Call to Action (Appendix\u00a0S1). The discussion confirmed that persisting barriers do not allow the full realisation of the public health potential of diagnosing and preventing hepatitis B and C, treating hepatitis B and curing hepatitis C. Such barriers are related to (a) lack of evidence\u2010based knowledge of hepatitis B and C, (b) limited access to prevention, diagnosis and treatment services with poor patient pathways, (c) declining resources and (d) the presence of social stigma and discrimination. The discussion also confirmed the emerging importance of fiscal constraints on the ability of policymakers to adequately address viral hepatitis challenges, particularly through increasing coverage of newer therapies. In Europe, it is critical that public policy bodies urgently agree on a conceptual framework for addressing the existing and emerging barriers to managing viral hepatitis. Such a framework would ensure all health systems share a common understanding of definitions and indicators and look to integrate their responses to manage policy spillovers in the most cost\u2010effective manner, while forging wide partnerships to sustainably and successfully address viral hepatitis.<\/jats:p>","DOI":"10.1111\/jvh.12493","type":"journal-article","created":{"date-parts":[[2016,1,26]],"date-time":"2016-01-26T09:58:59Z","timestamp":1453802339000},"page":"1-12","source":"Crossref","is-referenced-by-count":30,"title":["Addressing barriers to the prevention, diagnosis and treatment of hepatitis B and C in the face of persisting fiscal constraints in Europe: report from a high level conference"],"prefix":"10.1111","volume":"23","author":[{"given":"G.","family":"Papatheodoridis","sequence":"first","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. C.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Hepatology and Gastroenterology Section Department of Medicine Imperial College London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Golna","sequence":"additional","affiliation":[{"name":"Hepatitis B &amp; C Public Policy Association Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Mediche e Chirurgiche University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Carballo","sequence":"additional","affiliation":[{"name":"International Centre for Migration, Health and Development Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cornberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Endocrinology Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Dalekos","sequence":"additional","affiliation":[{"name":"University of Thessaly Medical School Karditsa Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Degertekin","sequence":"additional","affiliation":[{"name":"Acibadem University Medical School Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Dourakis","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Flisiak","sequence":"additional","affiliation":[{"name":"Medical University of Bialystok Bialystok Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Health Protection Scotland Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gore","sequence":"additional","affiliation":[{"name":"Hepatitis B &amp; C Public Policy Association Luxembourg Luxembourg"},{"name":"World Hepatitis Alliance The Hepatitis C Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Goulis","sequence":"additional","affiliation":[{"name":"Medical School Aristotle University Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hadziyannis","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Kalamitsis","sequence":"additional","affiliation":[{"name":"Hellenic Liver Patient Association \u201cPrometheus\u201d Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kanavos","sequence":"additional","affiliation":[{"name":"London School of Economics London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kautz","sequence":"additional","affiliation":[{"name":"European Liver Patients Association (ELPA) Sint\u2010Truiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Koskinas","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. R.","family":"Leite","sequence":"additional","affiliation":[{"name":"National Parliament Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Malliori","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Manolakopoulos","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Mati\u010di\u010d","sequence":"additional","affiliation":[{"name":"Viral Hepatitis Department Infectious Diseases Clinic University Medical Centre Ljubljana Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Papaevangelou","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pirona","sequence":"additional","affiliation":[{"name":"European Monitoring Center for Drugs and Drug Addiction Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Prati","sequence":"additional","affiliation":[{"name":"Alessandro Manzoni Hospital Lecco Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Raptopoulou \u2013 Gigi","sequence":"additional","affiliation":[{"name":"Hellenic Center for Disease Control and Prevention (HCDCP) Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Reic","sequence":"additional","affiliation":[{"name":"European Liver Patients Association (ELPA) Sint\u2010Truiden Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Robaeys","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepaatology Ziekenhuis Oost Limburg Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Schatz","sequence":"additional","affiliation":[{"name":"Correlation Network Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Souliotis","sequence":"additional","affiliation":[{"name":"University of Peloponnese Korinth Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Tountas","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Wiktor","sequence":"additional","affiliation":[{"name":"World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Wilson","sequence":"additional","affiliation":[{"name":"World Bank Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Yfantopoulos","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Hatzakis","sequence":"additional","affiliation":[{"name":"Medical School National and Kapodistrian University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,1,26]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"European Centre for Disease Prevention and Control (ECDC).Hepatitis B and C in the EU neighbourhood: prevalence burden of disease and screening policies 2010. Available at:http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/TER_100914_Hep_B_C%20_EU_neighbourhood.pdf(accessed 10 December 2013)."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26141"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.05.021"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199712113372406"},{"key":"e_1_2_8_6_1","unstructured":"World Health Organization (WHO).Regional office for Europe. Hepatitis B Fact Sheet No 204 2014. Available at:http:\/\/www.who.int\/mediacentre\/factsheets\/fs204\/en\/(accessed 5 December 2014)."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature04077"},{"key":"e_1_2_8_8_1","unstructured":"World Health Organisation (WHO).Guidelines for the screening care and treatment of persons with hepatitis C infection 2014. Available at:http:\/\/www.who.int\/hiv\/pub\/hepatitis\/hepatitis-c-guidelines\/en\/(accessed 10 December 2014)."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2011.02539.x"},{"key":"e_1_2_8_10_1","unstructured":"World Health Organization (WHO).Hepatitis Data and Statistics 2013.\u00a0Available at:http:\/\/www.euro.who.int\/en\/health-topics\/communicable-diseases\/hepatitis\/data-and-statistics(accessed 10 November 2014)."},{"key":"e_1_2_8_11_1","unstructured":"World Health Organization (WHO).Immunization Vaccines and Biologicals Hepatitis 2013. Available at:http:\/\/www.who.int\/immunization\/topics\/hepatitis\/en\/(accessed 6 October 2014)."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pra.0000358313.06858.ea"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2013.02.009"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2013.03.008"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26218"},{"issue":"16","key":"e_1_2_8_16_1","first-page":"1","article-title":"The burden of hepatitis C in Europe from the patients\u2019 perspective: a survey in 5 countries","volume":"13","author":"Vietri J","year":"2013","journal-title":"BMC Gatroenterol"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12132"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.01.011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23327"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61425-1"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.02.010"},{"key":"e_1_2_8_22_1","unstructured":"World Health Organization (WHO).Hepatitis C Fact Sheet No 164 2014. Available at:http:\/\/www.who.int\/mediacentre\/factsheets\/fs164\/en\/(accessed 2 May 2015)."},{"key":"e_1_2_8_23_1","unstructured":"ViktorS.Global control of viral hepatitis: Are the pieces falling into place? June 3\u20104. Athens High Level Meeting: Hepatitis B and C Public Policy Association; 2014. Report No.: Athens."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.144878"},{"key":"e_1_2_8_25_1","unstructured":"World Health Organization (WHO).Prevention and control of viral hepatitis infection: framework for global action 2012. Available at:http:\/\/www.who.int\/csr\/disease\/hepatitis\/Framework\/en\/(accessed 2 August 2014)."},{"key":"e_1_2_8_26_1","unstructured":"World Health Organization (WHO).World Health Assembly 67 Agenda Item 12.3 Hepatitis WHA67.6 2014. Available at:http:\/\/apps.who.int\/gb\/ebwha\/pdf_files\/WHA67\/A67_R6-en.pdf(accessed 5 September 2014)."},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12565"},{"key":"e_1_2_8_28_1","unstructured":"European Centre for Disease Prevention and Control (ECDC).Hepatitis B and C surveillance in Europe 2012 2014. Available at:http:\/\/www.ecdc.europa.eu\/en\/publications\/Publications\/hepatitis-b-c-surveillance-europe-2012-july-2014.pdf(accessed 10 November 2014)."},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12400"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2009.01.002"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2009.01.056"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.5812\/kowsar.1735143X.663"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.09.064"},{"key":"e_1_2_8_34_1","unstructured":"World Health Organization (WHO).Vaccine\u2010preventable diseases Hepatitis B 2013. Available at:http:\/\/www.euro.who.int\/en\/health-topics\/disease-prevention\/vaccines-and-immunization\/vaccine-preventable-diseases\/hepatitis-b(accessed 5 October 2014)."},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f4057"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03515.x"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12008"},{"key":"e_1_2_8_38_1","unstructured":"BruggmanP GrebelyJ.Prevention treatment and care of hepatitis C among people who inject drugs. Vienna 2014. Available at:https:\/\/www.unodc.org\/documents\/hiv-aids\/CND2014\/UNODC_SCIENTIFIC_EVENT_HCV_BRUGGMANN.pdf(accessed 5 November 2014)"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2011.03654.x"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12129"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit306"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit302"},{"key":"e_1_2_8_43_1","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).Prisons and drugs in Europe: the problem and responses 2012. Available at:http:\/\/www.emcdda.europa.eu\/publications\/selected-issues\/prison(accessed 2 September 2014)."},{"key":"e_1_2_8_44_1","unstructured":"World Health Organization (WHO).Global Database on Blood Safety Summary Report 2011 2011. Available at:http:\/\/www.who.int\/bloodsafety\/global_database\/GDBS_Summary_Report_2011.pdf(accessed 9 October 2014)."},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2010.02851.x"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.12096"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03319.x"},{"key":"e_1_2_8_48_1","unstructured":"Centers for Disease Prevention and Control (CDC).Health care settings and viral hepatitis 2011. Available at:http:\/\/www.cdc.gov\/hepatitis\/settings\/HealthcareSettings.htm(accessed 6 October 2014)."},{"key":"e_1_2_8_49_1","unstructured":"World Health Organization (WHO).Injection safety policy and global campaign 2015. Available at:http:\/\/www.who.int\/injection_safety\/global-campaign\/en\/(accessed 1 May 2015)."},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12183"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26246"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.2001.00310.x"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2012.09.012"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-S6-S14"},{"key":"e_1_2_8_55_1","unstructured":"CarballoM CodyR KellyM HatzakisA.Migration Hepatitis B and Hepatitis C 2013. Available at:http:\/\/www.hepbcppa.org\/wp-content\/uploads\/2011\/11\/Migration-report.pdf(accessed 3 October 2014)."},{"key":"e_1_2_8_56_1","unstructured":"JonesL AtkinsonA PorcellatoLet\u00a0al.A systematic review of qualitative research on the views perspectives and experiences of hepatitis B and C testing among practitioners and people at greatest risk of infection Final Report for the National Institute for Clinical Excellence 2011. Available at:https:\/\/www.nice.org.uk\/guidance\/ph43\/resources\/hepatitis-b-and-c-ways-to-promote-and-offer-testing-evidence-review-12(accessed 6 October 2014)."},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit263"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101554"},{"key":"e_1_2_8_59_1","unstructured":"World Health Organization (WHO).Guidelines for the screening care and treatment of persons with hepatitis C infection 2014. Available at:http:\/\/apps.who.int\/iris\/bitstream\/10665\/111747\/1\/9789241548755_eng.pdf(accessed 1 May 2015)."},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12248"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.01.003"},{"key":"e_1_2_8_62_1","unstructured":"World Health Organization (WHO).Health health systems and economic crisis in Europe. Impact and policy implications. Summary European Observatory on Health Systems and Policies 2013. Available at:http:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0011\/186932\/Health-and-economic-crisis-in-Europe4.pdf(accessed 4 September 2014)."},{"key":"e_1_2_8_63_1","unstructured":"RAND.Hepatitis C \u2010 A projection of the healthcare and economic burden in the UK 2013. Available at:http:\/\/www.rand.org\/content\/dam\/rand\/pubs\/technical_reports\/TR1300\/TR1307\/RAND_TR1307.pdf(accessed 10 April 2015)."},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12249"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjvh.12493","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjvh.12493","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.12493","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T18:11:14Z","timestamp":1694628674000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.12493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,26]]},"references-count":63,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/jvh.12493"],"URL":"https:\/\/doi.org\/10.1111\/jvh.12493","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,26]]}}}