Global Strategies for the Prevention and Control of Infectious Diseases and Non-Communicable Diseases

Nakatani, Hiroki

Taking these changes in parameters in mind, the global health cycle for NCD control needs to be studied. In the case of hepatitis as a cause of hepatic cancer, linkage within the cycle is not complete, despite the clear consensus, expressed by the World Health Assembly Resolutions in 2010 and 2013, to expand hepatitis programs. The first challenge has been the development of guidelines for hepatitis C, because a new but highly expensive drug has come onto the market in highincome countries. For the Japanese market, one tablet costs about 500 USD, and patients need to take the tablets daily for 12 weeks. Whether to put this new drug in the guideline or to stick to the traditional interferon-based treatment regimen is controversial: everyone wishes to bring new drugs into the guideline, but if the treatment is not implementable, it will not be useful for practice. A second challenge is the development of a new global strategy for hepatitis, including treatment targets. Setting targets is difficult because the majority of heavily affected countries are middle-income countries, where ODA is not available. Hence, all resources should be mobilized domestically under the responsibility of national governments. Such responsibility will be scrutinized by monitoring organizations, which encourage governments to set targets low to avoid issues of government accountability. Linkage of technical components with financial realities is essential to any completion of this circle.