Scotland Nears WHO Target for Hepatitis C Elimination
Scotland is edging closer to the World Health Organization’s hepatitis C virus (HCV) elimination target as a new modelling study reveals a significant drop in HCV incidence among people who inject drugs (PWID). The findings, drawn from one of the largest long-term cohorts of PWID, underscore the impact of sustained public health strategies and harm-reduction interventions in reducing new infections and moving toward WHO milestones.
What the Study Shows
The modelling focuses on incidence rates — the number of new HCV infections in a given population over time. By examining data from PWID across multiple years, researchers observed a steep decline in new HCV cases. While prevalence (the total number of people living with HCV) has historically driven attention, incidence is a crucial indicator of ongoing transmission and program effectiveness. A reduction in incidence suggests fewer people are acquiring the infection each year, a key step toward meeting elimination targets.
Why PWID Are Central to the Outcome
People who inject drugs represent a high-burden group for HCV transmission due to factors such as shared injection equipment and varying access to health services. Scotland’s public health approach has emphasized harm-reduction strategies, including needle and syringe programs, opioid substitution therapy, and accessible testing and treatment. These measures aim not only to treat existing infections but also to interrupt transmission chains, which is reflected in the new incidence data.
Implications for WHO Targets
The WHO has set ambitious milestones for HCV elimination, including substantial reductions in new infections and mortality by the target year. The observed decline in HCV incidence among PWID in Scotland suggests the country is moving along the right trajectory. While national benchmarks vary, a sustained drop in incidence is a strong signal that transmission is being curbed and that treatment scale-up is making a difference.
Policy and Programmatic Context
Several factors likely contribute to Scotland’s progress. Expanded access to direct-acting antiviral (DAA) therapies has improved cure rates, while targeted outreach and community-based testing help identify infections earlier, enabling timely treatment. Integrated care models that link testing, diagnosis, and treatment with social support services reduce barriers for PWID and enhance engagement in care. Public health authorities emphasize surveillance to monitor trends and adapt strategies in real time, a critical component when measuring progress toward elimination goals.
Future Outlook
Despite the encouraging signs, experts caution that continued vigilance is essential. Maintaining and expanding harm-reduction services, ensuring equitable access to testing and treatment, and addressing social determinants of health remain priorities. If low-incidence trends persist, Scotland could not only approach but potentially reach WHO’s HCV elimination target in the near term, serving as a model for other regions facing similar burdens.
What This Means for Communities
Beyond headline statistics, the incidence decline translates to real-world benefits: fewer new infections, reduced transmission in communities, and improved long-term health outcomes for people who use drugs. For PWID, this can mean greater trust in health services, higher testing uptake, and smoother pathways to cure. The story in Scotland emphasizes that strategic investment in prevention, testing, and treatment can redefine the trajectory of an infectious disease at the population level.
Conclusion
As Scotland inches toward the WHO hepatitis C elimination goal, the latest incidence data among PWID offers a hopeful message. Through a combination of harm-reduction programs, accessible treatment, and persistent surveillance, the country demonstrates how long-term commitment to public health can translate into measurable declines in new infections and progress toward ambitious international targets.
