In early April, Liver Health Connection board member Dr. Marcelo Kugelmas organized a delegation of U.S. hepatologists to educate and learn from hepatologists and gastroenterologists in Cuba. Pictured below are some of the attendees of the Hepatology and Liver Transplant Symposium in Havana, Cuba including doctors from the United States, Cuba and Spain as well as Liver Health Connection’s Executive Director Nancy Steinfurth.
The U.S. hepatologists shared their expertise in liver transplantation, hepatitis C treatment, liver cancer and non-alcoholic fatty liver disease among other topics. Dr. Zobair Younossi from Inova Fairfax Hospital in Virgina is shown here sharing an overview of hepatitis C treatment in the United States.
The Cuban doctors shared on their highly successful efforts to eradicate hepatitis B in the country. More than 99% of newborn are vaccinated for hep B and in 2016 the whole Cuban population under 36 years of age was covered by the vaccination program. Part of the success in HBV elimination is a the extensive medical care that women receive during pregnancy – pictured here is an old bank converted into clinic for pregnant women who receive daily monitoring during the final weeks of pregnancy.
As for hepatitis C prevention and treatment, the U.S. delegation was surprised to learn: 1) injection drug use is practically nonexistent in Cuba; and 2) pegelated interferon (which they produce in Cuba) is still the standard treatment for hep C on the island. Based on these two facts alone, it’s obvious the both countries can benefit from ongoing communication with each other about viral hepatitis.
The trip of course was not all shop talk. The delegation had the opportunity to see the country such as the Univeridad de Habana pictured here . . .
. . . and the Habor de Habana seen here.
How the Affordable Care Act (ACA) Helps People with Hepatitis B and C
Under the ACA, all new health plans and Medicaid expansion programs must offer free preventive services, including hepatitis B vaccination and hepatitis B and C testing. These services are essential to prevent new infections and link individuals to lifesaving care and treatment. The ACA also created the Prevention and Public Health Fund, which has improved access to the hepatitis B vaccine.
Expanded coverage for communities disproportionately affected by hepatitis C
African Americans have higher rates of hepatitis C than other ethnic groups. Since the ACA’s enactment, the uninsured rate has declined 59% for African Americans. The uninsured rate for veterans, who also have higher rates of hepatitis C, has dropped 42%. Because the ACA permanently authorized funds for the Indian Health Care Improvement Act, more Native Americans have gained coverage. The ACA has also expanded health coverage for an estimated 4.2 million Latino adults and 676,000 Latino children. Expanded coverage for these populations is crucial to eliminating hepatitis C.
The ACA prohibits private insurers from discriminating against people with pre-existing conditions. Before the ACA, people with pre-existing conditions like hepatitis B or C were often automatically denied coverage. The ACA’s protection of people with pre-existing conditions ensures that people with hepatitis B or C can be tested and treated.
No annual or lifetime limits
The ACA’s elimination of lifetime or annual limits on the amount of insurance available has enabled persons with viral hepatitis to successfully treat and manage their disease, saving lives and helping to stop new infections.
Expanded Medicaid eligibility
The ACA allows states to expand Medicaid to cover people with incomes at or below 138 percent of the federal poverty level, including single adults without children. In states with the Medicaid expansion, viral hepatitis prevention and care are now more accessible to low-income persons.
More affordable coverage
Under the ACA, the federal government provides financial assistance to many low-income people who obtain coverage through their state’s marketplace. Low-income people with hepatitis B or C need this assistance to receive core services.
Equal coverage for substance use disorders
The ACA requires insurers to offer equal coverage for substance use treatment. People who contracted viral hepatitis from opioid overuse can get treatment for their addiction as they would for any other medical condition.