After an ambitious campaign, in 2024 Egypt became the first country in the world to eradicate chronic hepatitis C as a public health threat — and England and Australia are nearly there, according to the World Health Organization.
But the U.S. is lagging far behind, with about 11,000 people dying every year from what has been a curable disease for a decade.
In Michigan, the good news is the number of chronic hepatitis C cases has plummeted, from about 10,000 in 2018 to just over 3,000 in 2022.
Dr. Natasha Bagdasarian, the state's chief medical executive, says she's proud of that achievement, especially notable because symptoms of the infection can take years to show up, so many people don't know they are infected.
"Chronic hepatitis C can be a truly terrible disease," she said. "It can lead to things like hepatocellular carcinoma. It can lead to liver cirrhosis. It can put people on the organ transplantation list."
The disease is spread by direct contact with infected blood, either from sharing needles for drug use, getting tattoos or piercings in unsterile settings, or accidental needle-sticks in healthcare settings. It can also be transmitted from a pregnant mother to a baby or, less commonly, through high-risk sexual activity.
Bagdasarian credits the progress in reducing hepatitis C in Michigan to the state's "We Treat Hep C" program, which — with the help of numerous community organizations — conducts outreach to people in vulnerable communities to boost testing for hepatitis C.
As part of its program, Michigan also negotiated a discounted price for the newest medication that cures hepatits C, Mavyret, which requires an eight-week course of medicine.
Without insurance, the out-of-pocket cost is more than $16,000 (or more than $12,000 through the discount drug plan GoodRx). But low-income people with Medicaid in Michigan can receive the pills for a nominal co-pay of $1, and there's no copay required for the Healthy Michigan Plan.
Bagdasarian said the complicated and fragmented health care system in the U.S. is a big barrier to the eradication effort, compared to countries that have universal health care coverage.
"The goal is to make hepatitis C detection and treatment available to everyone. But there are people who don't meet eligibility criteria for Medicaid but can't afford another form of health insurance. People who lose a job and end up without health insurance. People fall through the cracks."
Bagdasarian said more recent preliminary numbers show continued improvement in Michigan, with new hepatitis C cases identified in 2025 under 2,000.
