Essential components in developing public policy to control viral hepatitis: lessons from Taiwan.
BACKGROUND
Over 500 million people are estimated to be infected with chronic viral hepatitis with an increasing burden resulting from the infections. In 2010, the World Health Organization recommended national governments develop effective strategies to reduce the global impact of viral hepatitis. Taiwan, to support the implementation of the world's first national vaccination program, developed the first of a series of 5-year national strategies in 1982. Our study sought to identify the essential constituents of the strategic response to chronic viral hepatitis in Taiwan, which could then be used by other governments to inform best practice in strategy development.


METHODS
Semistructured qualitative interviews were conducted with key participants involved in the national response to viral hepatitis in Taiwan (n = 26) and a review of the literature.


RESULTS
The development of a national strategic response is one of several factors in reducing the burden of viral hepatitis in Taiwan. Other critical factors are effective health services, a prioritization of disease prevention, government funding of science and technology, and sustained advocacy informed by a rigorous evidence base. While there has been significant policy, structural and financial commitment to reduce the burden of related to viral hepatitis, essential challenges remain.


CONCLUSIONS
Taiwan's viral hepatitis policy response focuses on clinical interventions and would be strengthened by a broader involvement of interdisciplinary stakeholders, including people with viral hepatitis, and stronger coordination between the policy and government agencies responsible for their implementation.
Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia. J.Wallace@latrobe.edu.au.
Jack
J
Wallace
Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia. M.Pitts@latrobe.edu.au.
Marian
M
Pitts
Research and Molecular Development, Victorian Infectious Diseases Reference Laboratory, WHO Regional Reference Laboratory for Hepatitis B, Doherty Institute, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia. Stephen.Locarnini@mh.org.au.
Stephen
S
Locarnini
Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia. J.Ellard@latrobe.edu.au.
Jeanne
J
Ellard
Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia. M.Carman@latrobe.edu.au.
Marina
M
Carman
Department of Internal Medicine, Genomics Research Center, Academia Sinica, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. chends@ntu.edu.tw.
Ding-Shinn
DS
Chen
D006078:Government Programs / Q000331:legislation & jurisprudence*; D006525:Hepatitis, Viral, Human / Q000517:prevention & control*; D006801:Humans; D032541:Mass Vaccination / Q000379:methods / Q000458:organization & administration; D011322:Primary Prevention / Q000331:legislation & jurisprudence / Q000379:methods*; D011634:Public Health / Q000331:legislation & jurisprudence / Q000379:methods; D011640:Public Policy / Q000331:legislation & jurisprudence*; D013624:Taiwan
National health programs; Policy assessment; Taiwan; Viral hepatitis