As President of Hepatitis Australia, I am honoured to present this Strategic Plan 2025-2030. The plan represents Hepatitis Australia’s unwavering resolve to end the epidemics of hepatitis B and hepatitis C and create positive changes that improve the lives of people living with its impacts, including liver disease.

Partnerships

In the plan, Hepatitis Australia affirms the central role of its members – the leading community hepatitis organisations in each state and territory – in governing our organisation. We celebrate their community leadership as representatives of people affected by hepatitis B and hepatitis C. This plan identifies new measures through which Hepatitis Australia will provide a platform for the voice and involvement of people affected by hepatitis B and hepatitis C, including people with lived experience.

Representing the interests of communities affected by hepatitis B and hepatitis C, Hepatitis Australia affirms in this plan its deep commitment to partnership – with researchers who provide evidence to light the way, clinicians who provide life-saving treatment and care, and parliamentarians and governments whose sustained engagement and support we need to achieve our vision. We will advocate with renewed urgency for the needs of affected communities to drive policy change.

Professor Joseph Doyle
President Hepatitis Australia

"Hepatitis Australia and its members are globally unique in being funded by governments to represent the needs of people living with viral hepatitis.
This allows for people with lived experience to be intrinsically involved in a partnership with government, researchers, clinicians and others to support the elimination of viral hepatitis.

Dr Jack Wallace
Founder and Executive Officer (1998 - 2005) Hepatitis Australia

About this plan

Enormous progress has been made responding to hepatitis B and hepatitis C through the dedication of members, clinicians, researchers, governments and, most importantly, people who navigate their experience of these conditions each day. While not as prevalent, this plan gives new attention to hepatitis A and hepatitis E, which are not usually chronic, and hepatitis D, which is only acquired by people with hepatitis B and which makes that infection more serious. We have also set out priorities to address the serious, often life-long health impacts of hepatitis B and hepatitis C and have highlighted the devastating global toll of these infections.

This plan sets an agenda. Alongside this Strategic Plan is an Implementation Plan that describes Hepatitis Australia’s strategic priorities and the timeframes for their implementation.

In delivering this Strategic Plan, we will see enormous change in the journey to 2030. Not least, Hepatitis Australia will progressively complete the actions we have set. We can anticipate some of the larger changes ahead but, of course, not all. For this reason, Hepatitis Australia will renew this plan at its mid-point in late 2027 or as circumstances demand.

"It is now possible to imagine a future where vaccination and other prevention strategies, earlier diagnosis, and the highest quality peer support, treatment and care can free people with hepatitis B and hepatitis C from its impacts. However, all of this depends on community action to educate, provide support and promote testing and treatment. There is much to be done.

Resourcing is essential

This plan is ambitious. It is grounded in the needs of members and communities and sets out the efforts and leadership that Hepatitis Australia must provide. We have not limited our ambition to the things we are funded for. Instead, we boldly lay claim to the contribution Hepatitis Australia must make if Australia is to achieve elimination. This is Hepatitis Australia’s goal, and it is also the goal of Australian governments. Among the most important and urgent priorities is for Australian governments to fund the implementation of the National Hepatitis B and Hepatitis C Strategies, which they each endorse.

Economic modelling independently commissioned by Hepatitis Australia has shown Australia can achieve its elimination targets for hepatitis B and hepatitis C with modest investment in the period to 2030. For hepatitis C, substantial progress is possible with annual investment of between $9.9m and $17.7 million.[1] For hepatitis B, the annual investment range is between $10.4m and $27.2m.[2]

Australian governments have launched successive National Hepatitis B and Hepatitis C Strategies that are big on ambition yet short on the financing needed for their implementation. Choosing to be ambitious is no different to choosing to deliver – both are decisions that are available to governments. We already spend far more on viral hepatitis healthcare than these modest funding targets. The Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS) at national level and hospital and other services at state and territory level cost hundreds of millions of dollars each year. Yet coordinated program funding to drive the elimination agenda is where we have fallen short, despite best efforts. Adequately funding the elimination agenda will save avoidable costs in the long run.

Meaningful national and state and territory program investment is needed to grow and support the community workforce whose efforts are needed to achieve elimination. Given the scale of financing failure to date, additional pathways must also be considered. These could include building hepatitis B and hepatitis C financing and accountabilities into Commonwealth and state and territory health agreements, scope of practice changes that allow a wider range of health professionals, including trained peers, to perform to their capability and access the MBS, and declaring hepatitis B to be a priority for Primary Health Networks with higher incidence.

Hepatitis Australia hopes the newly emerging Australian Centre for Diseases Control (CDC) will be a catalyst for new thinking on how Australia finances its responses to communicable diseases. We commit to new partnership with the CDC and look forward to the mutual benefits it offers.

[1] HTAnalysts, National Hepatitis C Project Modelling Results, HTAnalysts, Sydney, 2024.

[2] HTAnalysts, National Hepatitis B Project Modelling Results, HTAnalysts, Sydney, 2024.

Hepatitis Australia’s role as a federation

In this plan, we have set out two vital roles for Hepatitis Australia. First, to serve and champion Hepatitis Australia’s members in their work providing peer and community support, education and frontline services to communities. Their work is driven by the effects of stigma and discrimination, criminalisation and injustice, migration and settlement, cost of living pressures and other pervasive barriers to care. These are not exceptional issues for most people affected by hepatitis B and hepatitis C but are characteristic of people’s everyday experience. Australian governments are yet to properly invest in Hepatitis Australia’s members whose credibility and trust allow them to overcome these barriers in connecting people to prevention, testing, treatment and care. As the federation for Australia’s leading community hepatitis organisations, Hepatitis Australia’s role includes coordinating members’ efforts nationally, supporting professional development of the community workforce and building the evidence for community action.

With effective vaccines, treatment and even a cure available, uptake remains the biggest challenge. Most of the progress towards hepatitis C elimination has resulted from the rollout of direct-acting antivirals (DAAs). This rollout has been clinically focused – initially through specialists, then expanding into primary care through general practitioners and later nurse practitioners and now implemented through pilot research programs. That has gotten Australia to where we are, but we are no longer going anywhere fast. Peer and community-led initiatives that support people with hepatitis B and hepatitis C in their engagement with care must be resourced at scale if elimination is to be achieved.

Hepatitis Australia’s role as a peak body

The second role for Hepatitis Australia follows from the first. Hepatitis Australia’s members can succeed only to the extent that social, financial and health system barriers are overcome. Community hepatitis organisations cannot connect people to hepatitis B treatment and care if they are not eligible for Medicare. And we will not eliminate hepatitis B or hepatitis C while medical and nurse practitioners are restricted from prescribing treatment. In Australia, many people still have blood tests at two clinic visits for a hepatitis C diagnosis and we pointlessly count hepatitis C antibody results rather than current infection. Ingloriously, Australia is one of the few high-income countries globally to not know how many neonates are acquiring hepatitis B. While these challenges play out locally in communities across Australia, the solutions are national.

Hepatitis Australia’s second role then is to find solutions to systemic challenges and advocate for their implementation. We do so by sharing real-time community intelligence from members with the Australian Government on the challenges and their solutions. For all the progress Australia has made, there are simply too many unaddressed barriers. Each one is a needless obstacle to people’s right to health. Hepatitis Australia cannot achieve this alone. It will require our best efforts, and the collaboration of members, community, research, clinical and government partners to achieve the changes needed.

We acknowledge the leadership of Australian governments, not least in providing hepatitis B vaccination for infants and subsidised treatment for hepatitis C. The decision to make hepatitis C treatment available in prisons reminds us that far-sighted policy choices are possible. More decisions like these will be needed to achieve elimination, including to provide people in prison with access to sterile injecting equipment.

"This is a plan about people. Remarkable people. Ordinary people. People whose backgrounds and experiences are extraordinarily diverse. The common experience uniting these people is their risk and experience of liver disease, brought about by very different conditions – hepatitis B and hepatitis C, experienced chronically by more than 280,000 people in Australia; hepatitis D, which is only acquired by people with hepatitis B and which makes that infection more serious; and hepatitis A and hepatitis E, which are usually acute and associated with outbreaks. We describe these conditions together as viral hepatitis.”

To 2030 and beyond

Australia’s National Hepatitis B and Hepatitis C Strategies commit to eliminating these conditions as public health threats by 2030. This means Australia will have achieved the global elimination targets that guide the national strategies and attained a high level of control over the incidence, diagnosis and treatment and care of hepatitis B and hepatitis C. Elimination will be achieved progressively, with some targets reached earlier, and for different populations and in different places, than others.

The global hepatitis B and hepatitis C epidemics mean Australians will continue to acquire these conditions when travelling and migrants in Australia will remain priority communities for prevention, testing, treatment and care. Elimination will improve countless lives but the work will not be over until there is an end to viral hepatitis for all.

Hepatitis Australia is clear in its 2030 vision, but many developments will occur in that time that we cannot anticipate. Some we hope for: a cure for hepatitis B. Others will be surprises, requiring agility to navigate opportunities and risks. The rapid advancement of artificial intelligence will demand courage in leveraging its possibilities, and clear-eyed fortitude to safeguard against its considerable risks.

The possibilities for linking large data sets are maturing in Australia. It will soon be possible to link information about who has been diagnosed with hepatitis B and hepatitis C with information about who has been prescribed treatment or is undergoing hepatitis B viral load monitoring. This would identify everyone who is disconnected from care and open the possibility of direct community support for the individual or their health practitioner to renew that connection.

Sensitive action based on this information could prevent thousands of people from needlessly progressing to liver disease, cancer and death. The ethical imperative here is evident – it is to enable the conditions for each person’s right to health. The alternative – to know who is not benefiting from monitoring, treatment and cure and fail to act – is not an option. Hepatitis Australia must be at the vanguard of dialogue on how transformative possibilities such as these can, with considered safeguards, informed by lived experience, be fully realised.

Hepatitis Australia’s vision is to eliminate viral hepatitis for all. Our purpose is to end transmission and achieve the best health for people with viral hepatitis. We are guided by our values of curiosity, innovation, respect, equity, human rights, partnership, impact and accountability.

As we commence delivery of this new Strategic Plan, together, we can achieve the elimination of hepatitis B and hepatitis C by 2030.

On behalf of Hepatitis Australia’s Board,

Professor Joseph Doyle

President Hepatitis Australia

When elimination is achieved, there will still be people acquiring and living with hepatitis B and hepatitis C, but transmission will be lower and monitoring, treatment and quality of life will be higher.

Community, clinical, research and government action will be needed to sustain elimination.