Cross-posted from the HHS.gov Hepatitis blog


Hawai’i has one of the highest rates of liver cancer in the United States. Hepatitis B and hepatitis C are the leading causes of liver cancer in the state and could affect up to 63,000 people across the islands. Most adults at-risk for and living with chronic hepatitis B or chronic hepatitis C do not know it and therefore do not access hepatitis screening, vaccinations and/or treatment. To address this health crisis, Hep Free Hawai’i (HFH) released the state’s first hepatitis elimination plan on July 28, 2020 to coincide with World Hepatitis day.

What is Hep Free Hawai’i?

HFH is a community-driven coalition of local, national, and global partners dedicated to increasing awareness of and access to viral hepatitis and harm reduction services throughout the state of Hawaii. Started as a partnership between the Hawaii Department of Health, the CHOW Project (the statewide syringe exchange now known as the Hawai’i Health & Harm Reduction Center), and other community agencies, Hep Free Hawai’i connects with communities across the islands to work towards elimination of viral hepatitis and related harms such as overdose, wounds, homelessness, discrimination, and more.

How is Hep Free Hawai’i working toward hepatitis elimination?

HFH kicked off its elimination planning on World Hepatitis Day in 2019 and since then engaged with over 160 individual stakeholders in more than 24 formal meetings, multiple online surveys, and many more informal conversations to create the structure of the plan, establish its scope (viral hepatitis A, B, and C), and identify elimination priorities, strategic directions, and examples of micro-elimination opportunities. The strategy reflects the values and insights of many diverse stakeholders, from syringe exchange participants and Pacific Islander migrants to legislators and Hawai'i’s Lieutenant Governor.

HFH collectively decided that the final strategy document should be usable by community members, and so it is highly visual with a focus on readability. Hep Free 2030: The Hawai’i Hepatitis Elimination Strategy 2020-2030 (Hep Free 2030) identifies five priorities that align with the coalition’s core values of harm reduction, social justice, intersectionality, and aloha. These priorities include:

  • Awareness and education
  • Access to services
  • Advocacy at all levels
  • Equity in everything
  • Data for decision-making

Within each of these priority areas, the plan includes strategic directions, or specific actions that the coalition partners will take to advance progress in each of the priority areas. The strategy also notes opportunities for micro-elimination efforts, which are key for a localized approach. HFH conceptualizes micro-elimination as working on many different, innovative, community-driven projects at the same time, which allows advocates to tailor hepatitis elimination to the needs of each community and to change direction quickly if things aren’t working.1

These integrated, collaborative, and nimble strategies and actions contribute to Hep Free 2030’s aim to eliminate hepatitis in Hawai’i along the continuum of care.

Where can people learn more about Hawai’i’s efforts?

For more information about Hep Free Hawai’i and Hep Free 2030, visit https://www.hepfreehawaii.org/hep-free-2030. This link includes a copy of the strategy, a 1-page summary, and a recording of the launch event.

HFH is also creating an interactive web version of the strategy. Stay connected and tune in to updates via social media (@hepfreehawaii).

Visit Mapping Hepatitis Elimination in Action to learn more about elimination efforts in Hawai’i and across the United States.

Related pages and posts:

1adapted from Lazarus JV, et al. The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations. Semin Liver Disease. 2018 Aug;38{3): 181-192.