Scotland on track for WHO hepatitis C elimination
New modelling indicates Scotland is edging closer to the World Health Organization’s (WHO) hepatitis C virus (HCV) elimination target, highlighting a significant decline in new infections among people who inject drugs (PWID). The findings come from one of the longest-running studies of HCV transmission in the country, underscoring the impact of sustained public health measures, harm reduction, and access to treatment.
What the numbers show
The latest analysis reveals a steep drop in HCV incidence within the PWID community, a key demographic for transmission. By focusing on this group, researchers can gauge the effectiveness of a comprehensive national strategy that combines harm reduction services, expanded testing, and early treatment access. While prevalence (the total number of people living with HCV) remains a concern for health systems, incidence (new infections) is the critical metric for judging progress toward elimination goals.
Why PWID are central to the strategy
PWID have historically driven HCV transmission in Scotland. Targeted interventions—such as needle and syringe programs, opioid substitution therapy, and robust links to hepatitis C testing and antiviral treatment—have reduced risky behaviours and increased cure rates. The current modelling suggests these measures are not only preventing new infections but also reducing ongoing transmission chains within communities.
Policy actions that drive results
Scotland’s approach combines public health campaigns with tangible services:
– Expanded access to DAA (direct-acting antiviral) therapies, which can cure most HCV infections.
– Wide-scale testing initiatives to identify asymptomatic cases early.
– Harm reduction programs that provide safer injecting equipment and support services to PWID.
– Strong linkages to care, ensuring people who test positive begin treatment promptly.
Long-term studies building confidence
The study in focus spans many years, offering a robust lens on how HCV transmission responds to policy and practice changes. Longitudinal data are especially valuable in infectious disease elimination efforts, where short-term fluctuations can mask the true trajectory. The current results provide policymakers and health professionals with evidence that Scotland’s strategy is moving the country toward the WHO target ahead of schedule.
Implications for the health system
With incidence falling, Scotland faces different pressures: ensuring continued funding for prevention and testing, maintaining high treatment uptake, and monitoring for potential shifts in transmission patterns. The data also reinforce the value of integrated care models that treat HCV alongside other substance use and infectious disease services, reducing barriers to care for PWID and other at-risk groups.
What this means for patients and the public
For individuals living with HCV or at risk of infection, the trajectory toward elimination translates into better access to life-saving treatment and more opportunities for early diagnosis. For communities, lower incidence reduces the broader public health burden, potentially freeing resources to tackle related health issues while sustaining momentum toward the WHO target.
Next steps toward elimination
Experts emphasise the importance of maintaining a resilient health system that can adapt to changing patterns of drug use, migration, and healthcare access. Ongoing surveillance, regular data publication, and community-engaged programs will be essential to keep Scotland on course for complete elimination of hepatitis C as a public health threat.
Conclusion
Scotland’s declining HCV incidence among PWID marks a meaningful advance toward the WHO hepatitis C elimination goal. The blend of harm reduction, proactive testing, and accessible treatment demonstrates how well-coordinated public health strategies can translate into real-world outcomes, offering a roadmap for other nations pursuing similar targets.
