Scotland closes in on WHO hepatitis C elimination target
Scotland is edging closer to the World Health Organization’s hepatitis C virus (HCV) elimination target, buoyed by new modelling that indicates a steep fall in HCV incidence among people who inject drugs (PWID). Public health researchers say the trend reflects sustained investments in harm reduction, increased access to testing and treatment, and ongoing prevention efforts that have reshaped the HCV landscape in Scotland over the last decade.
What the modelling shows
Forecasts based on longitudinal data suggest that new HCV infections among PWID are declining at a rate that could meet or surpass the WHO’s elimination benchmarks. The models account for factors such as harm-reduction service coverage (including needle and syringe programs), opioid substitution therapy, and the rollout of highly effective direct-acting antiviral (DAA) treatments. While the epidemic remains concentrated in certain communities, the overall incidence trend points to meaningful progress toward elimination.
Why PWID are a focal point
People who inject drugs have historically borne the highest burden of HCV transmission in Scotland. Targeted interventions—harm reduction, regular testing, and rapid treatment initiation—are central to reducing the pool of infectious individuals and interrupting transmission networks. The latest data imply that these strategies are translating into measurable declines in new infections among PWID, a critical step toward reducing HCV prevalence nationally.
Progress in prevention and treatment
Scotland’s public health program has long emphasised a comprehensive approach to HCV: expanding access to confidential testing, routing individuals into care promptly, and ensuring DAAs are affordable and widely available. In practice, this means community-based testing events, GP and needle exchange site referrals, and streamlined pathways to cure. The result is not only fewer new infections but also improved health outcomes for those already living with HCV.
Implications for broader elimination goals
Experts caution that while the trajectory is encouraging, elimination as a public health problem requires sustained effort and monitoring. Challenges remain, including addressing disparities in access across rural areas and ensuring continued funding for prevention services. However, the current decline in incidence among PWID is a strong indicator that Scotland’s combination prevention and treatment strategy is working and could serve as a model for other regions seeking WHO alignment.
What comes next for Scotland
Public health authorities are expected to maintain aggressive testing campaigns, monitor incidence and treatment outcomes, and adapt services to evolving patterns of drug use and healthcare access. If the current momentum continues, Scotland could not only meet but potentially exceed some of the WHO targets for incidence reduction and disease elimination, delivering lasting benefits for communities disproportionately affected by HCV.
Conclusion
The latest modelling reinforces the narrative that Scotland’s integrated approach to HCV prevention and care is making a meaningful impact on transmission among PWID. While continued vigilance is essential, the near-term outlook suggests the country is moving decisively toward the WHO hepatitis C elimination target, with potential implications for regional and international public health strategies.
