More than 60 U.S. advocacy organizations have signed a letter urging President Trump and his administration to invest more money in hepatitis elimination — alleging that the country is lagging in its quest to end its hepatitis C virus (HCV) and hepatitis B virus (HBV) epidemics by 2030, the National Viral Hepatitis Roundtable reports.

The letter specifically asks Trump to invest in the Department of Health and Human Services’ (HHS) National Viral Hepatitis Action Plan and commit in both words and deeds to the elimination of HCV and HBV in the United States by 2030. This goal was initially established by the World Health Organization (WHO). Nine countries— Australia, Brazil, Egypt, Georgia, Germany, Iceland, Japan, the Netherlands and Qatar—are currently on track to achieve this goal; however, the United States, one of the richest countries in the world, is not among them.

The document also calls out HHS’s notable absence at this year’s World Hepatitis Summit, where nearly 1,000 people met in Sao Paulo, Brazil, to discuss global hepatitis elimination. The letter notes that despite the fact that the National Academies of Sciences, Engineering and Medicine released “A National Strategy for the Elimination of Hepatitis B and C” last spring, no new resources have yet been allocated at the national level to combat viral liver disease in this country.

How much is necessary to combat the crisis? A recent budget report by the U.S. Centers for Disease Control and Prevention (CDC) recommended that the government commit $308 million for FY2018 to meet the goals established by the National Viral Hepatitis Action Plan. However, the Division of Viral Hepatitis’s current funding stands at only $34 million. Advocates say these resources would help federal, state and local health departments build the necessary infrastructure to combat the epidemic — largely by increasing surveillance, testing and education efforts nationwide for the viruses.

The letter also recommends several key steps the government could take to help better combat the crisis and keep pace with international elimination efforts. These include establishing a coordinated elimination effort at the highest levels of the U.S. government; opening up access to harm reduction programs, such as syringe exchanges and medication-assisted treatment for opioid users; and improving insurance coverage for hepatitis care.

“Delayed action will result in continued high rates of liver cancer and future generations being needlessly infected with these life-threatening conditions,” the report concludes. In addition to NVHR, the letter was signed by well-known advocacy groups, including AIDS United, the Harm Reduction Coalition, Hep B United, NASTAD, Project Inform, the San Francisco AIDS Foundation, The AIDS Institute, VOCAL-NY and more.