Known as the Show Me State, Missouri unveiled a plan to eliminate hepatitis C, fittingly titled Show Me the Cure. The plan focuses on five different areas that together offer a road map to ending hepatitis C in Missouri, according to the state’s Department of Health and Senior Services (DHSS), which oversees the plan along with the Bureau of HIV, STD and Hepatitis.

About 40,300 people were living with hepatitis C in Missouri between 2013 and 2016, according to, which tracks and maps related data. In 2017, hep C caused 247 deaths in the state.

Hepatitis refers to inflammation of the liver. Untreated, it can lead to scarring of the liver (cirrhosis), liver cancer, the need for a liver transplant and death. Hepatitis can be caused by several factors, including toxins, excess alcohol use, autoimmune diseases, fat in the liver and viruses, including the three most common ones: hepatitis A, B and C. The good news is that hep C is curable. Modern treatments are highly effective and come with few side effects; they often consist of daily tablets taken for a few weeks.

“It is important that Missourians have access to services for testing and treatment,” said Paula Nickelson, acting director of DHSS, in a press release. “We will use this plan to increase prevention, testing and treatment services through policy development and advocacy efforts.”

According to the DHSS, the Show Me the Cure plan focuses on these five areas and related goals:

Access to Services

  • Increase the proportion of people who are tested and aware of their hepatitis C status.
  • Develop linkage to care for confirmatory testing and treatment.

Provider Development

  • Increase the number of health care providers who are trained to identify, diagnose and treat people with hepatitis C.

Education, Collaboration and Awareness

  • Increase awareness of testing and treatment for people living with hepatitis C.
  • Educate Missourians on health equity, stigma and cultural humility regarding hepatitis C.


  • Evaluate the current hepatitis C surveillance system.
  • Improve the quality and completeness of hepatitis C data, including improved demographics and risk factor data reporting.
  • Routinely analyze and disseminate findings and utilize hepatitis C data to develop and improve testing and linkage-to-care programs.
  • Identify data resources and collaborate with other organizations to compile information regarding HCV populations. 

Policy and Advocacy

  • Increase awareness of services for patients, and increase opportunities for advocacy.
  • Increase awareness regarding policies and laws that create barriers to hepatitis C testing and treatment.
  • Encourage and promote hepatitis C universal screening in primary care and other settings that provide services to those at highest risk.

It’s estimated that 2.4 million Americans were living with chronic hep C between 2013 and 2016 (about 1% of the adult population), according to the Centers for Disease Control and Prevention. What’s more, 14,242 people died of hepatitis C in 2019, and acute hep C cases quadrupled from 2009 to 2019. These numbers will likely climb, spurred by the opioid crisis and injection drug use. (Some 108,000 Americans died of drug overdoses in 2021, a new record.)

According to “Hepatitis C Transmission and Risk,” part of Hep’s Basics of Hepatitis, hep C is most easily spread through:

  • Sharing needles and other equipment (paraphernalia) used to inject drugs
  • Blood transfusions and organ transplants before July 1992
  • Sexual contact with someone who has hep C
  • Having a mother who had hep C when you were born.