By Chris Taylor, Director, Viral Hepatitis, NASTAD
Last month, Julie Scofield, Executive Director of the National Alliance of State and Territorial AIDS Directors (NASTAD), was recognized by the White House Office of Drug Control Policy (ONDCP) and Office of National AIDS Policy (ONAP) for her leadership in the prevention and treatment of viral hepatitis. The event was held at the White House in observance World Hepatitis Day. NASTAD congratulates Julie Scofield and other colleagues recognized for their leadership to address the domestic and global viral hepatitis epidemics.
NASTAD’s Viral Hepatitis Policy and Program Activities
NASTAD represents the nation’s chief state health agency staff who have programmatic responsibility for administering HIV/AIDS and viral hepatitis healthcare, prevention, education, and supportive service programs funded by state and federal governments. NASTAD’s viral hepatitis program began in 2000 with a goal of providing guidance and technical assistance to Viral Hepatitis Prevention Coordinators (VHPC) and other health department staff to strengthen the capacity of state and local health departments to develop, maintain and enhance comprehensive viral hepatitis programs.
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Since its founding in 1992, NASTAD has been concerned about the role of substance use in the transmission of HIV (and later hepatitis C virus (HCV)), health outcomes for persons living with HIV and viral hepatitis who use drugs, and the structural and policy barriers to effectively address the prevention, care and treatment needs of persons who inject drugs.
Through 20 years of experience, NASTAD has created an extensive national network of health department staff to provide peer-to-peer TA on the implementation of policies and programs. Health department staff have first-hand expertise in viral hepatitis program design, implementation and evaluation. Peers have met challenges and created innovative strategies that can be adapted by those facing similar challenges in another state.
In 2007, 2011 and 2013, NASTAD convened the National Viral Hepatitis Technical Assistance Meeting – the only national meeting focused exclusively on the public health response to viral hepatitis in the U.S. NASTAD will convene another Technical Assistance meeting in October 2014.
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Frustrated by the lack of federal investment in hepatitis prevention, NASTAD worked with other hepatitis advocates to form the Hepatitis Appropriations Partnership (HAP) in 2004 to increase congressional awareness of viral hepatitis and specifically call for increases in the CDC Division of Viral Hepatitis (DVH) budget. Despite a challenging budget environment and congressional resistance to disease specific funding, HAP has increased the DVH budget by $10 million – a nearly 50 percent increase. While this is nowhere near the funding needed to adequately address viral hepatitis in the U.S. – most other health programs are experiencing budget reductions.
Over the years, NASTAD has been involved in several initiatives which have advanced the viral hepatitis advocacy movement and populations most impacted:
- Published several important advocacy documents including:
- Founding member of the World Hepatitis Alliance, which successfully advocated for the World Health Organization to officially sanction World Hepatitis Day.
- While NASTAD staff was Chair of National Viral Hepatitis Roundtable (NVHR), raised funds to support the Institute of Medicine Report on Viral Hepatitis – a recommendation of which was for the federal government to develop a hepatitis action plan.
- Led efforts to secure the first ever presidential statement on viral hepatitis, World Hepatitis Day proclamation, and the first of several White House World Hepatitis Day events.
- Led community efforts calling for the creation of the Congressional Hepatitis Caucus.
- Issued a Statement of Commitment to Promoting Injecting Drug User Health – calling for increased attention for the infectious disease and overdose prevention needs of people who use drugs.
- Released the first technical assistance document describing opportunities for viral hepatitis in the Affordable Care Act (ACA).
- Organized (with the Harm Reduction Coalition) the first congressional briefing on HCV among young people who inject drugs.
- NASTAD convened (with the National Medical Association and Coalition on Positive Health Empowerment) one of the first national meetings focusing on hepatitis C and African Americans.
In an effort to formally acknowledge the importance of the organization’s viral hepatitis work and leadership, NASTAD updated its strategic map in 2006 to include viral hepatitis and in 2010, the full membership unanimously approved expanding the organization’s mission to explicitly include viral hepatitis.
Despite receiving no federal funding for viral hepatitis work, NASTAD continues to provide programmatic support and technical assistance to the VHPC and other health department staff and leads advocacy efforts to raise awareness among policy makers and increase the federal investment in viral hepatitis prevention, care and treatment and research. NASTAD’s vision is a world free of HIV/AIDS and viral hepatitis.