By Meg Heckman / Monitor staff
December 13, 2010article tools
In 1998, a report approved by Congress contained stark warnings about the HCV epidemic, decrying "uneven" disease reporting and surveillance, "uncoordinated" research, and limited education on prevention and treatment.
"Unless confronted more boldly, more directly, and more loudly," the report continued, "the threat posed by hepatitis C will only grow more ominous."
In the 12 years since, little has changed. There is no nationwide system of tracking infections, and an estimated 78 percent of HCV-positive Americans have no idea they're infected.
Deaths attributed to the virus are expected to triple in the next two decades, and annual HCV-related medical costs could reach $87 billion by 2027.
Many private organizations are working to stymie the virus, but public health experts believe that only the federal government has the wherewithal to coordinate a proper response to the epidemic, and they say current resources aren't up to the task.
The Centers for Disease Control and Prevention's Division of Viral Hepatitis is slated to receive $21 million next year, about $4 million less than in 2001.
Earlier this year, a report by the Institute of Medicine, a health policy think tank, pointed to a lack of public funding as one reason why services for Americans with hepatitis B and hepatitis C "are both limited and fragmented." In March, a group called the National Viral Hepatitis Roundtable warned that "systemic under-funding . . . puts millions of Americans' health and well being at risk"
Some corners of the government have been more responsive than others. The National Institutes of Health spent about $100 million last year on HCV-related research, plus millions more on research examining all liver diseases.
The Veterans Administration routinely screens patients for the virus and maintains several hepatitis C resource centers, plus a website full of educational materials for doctors and patients. (Veterans, particularly those from the Vietnam era, are more likely to be HCV-positive than the general population because of exposure to blood during combat or in battlefield hospitals.)
Over the years, some lawmakers have tried to broaden the government's response by introducing dozens of bills aimed at raising awareness of the disease and allotting enough money to fully fund a CDC plan to manage the epidemic.
Their attempts have been largely unsuccessful.
• In 2002, the Liver Research Enhancement Act was first introduced. It would have established a national center devoted to liver disease research and required the government to fund projects the center deemed crucial to public health. The bill never made it out of committee.
• In 2003, the Hepatitis C Epidemic Control and Prevention Act was introduced. It directed the CDC and NIH to institute a plan to prevent, control and treat the virus, and called for the creation of a liver disease research advisory board. A formal hearing was held the following year, but the bill died in committee at the end of the 108th Congress.
• In 2005, Congress took up the Liver Research Enhancement Act for the third time in six years. It died in committee again.
• In 2007, Sen. Ted Kennedy introduced an updated version of the Hepatitis C Epidemic Control and Prevention Act that would have appropriated $378 million for HCV prevention efforts over the following five years. The bill was referred to committee and died.
• Last year, California Rep. Mike Honda introduced the Viral Hepatitis and Liver Cancer Control Act of 2009, which requested $90 million for the prevention and treatment of hepatitis B and hepatitis C. Honda was joined by two colleagues with personal knowledge of liver disease: U.S. Rep. Mike Cassidy, who is a hepatologist, and U.S. Rep. Hank Johnson, who was undergoing treatment for HCV.
Their efforts garnered support from public health officials and hepatitis patients. Congress held another hearing. The act has 74 sponsors, including U.S. Rep. Carol Shea-Porter of New Hampshire. Last October, the bill was referred to committee. It's expected to die there when Congress adjourns later this month. 作者: wonder4078 时间: 2010-12-29 12:30