2024 Call For Expressions of Interest For Hepatitis Evaluations To Amplify Testing and Treatment (HEAT) Project

Grants Amount: $50,000


2024 Call for Expressions of Interest for Hepatitis Evaluations to Amplify Testing and Treatment (HEAT) Project
29 March 2024
The Coalition for Global Hepatitis Elimination is accepting expressions of interest for the Hepatitis Evaluations to Amplify Testing and Treatment (HEAT) project. The HEAT project provides catalytic grants for conducting assessments to inform the development of national hepatitis B (HBV) and/or hepatitis C (HCV) testing and treatment programs. The HEAT project was launched in 2020 and has since been completed in 7 countries.

Over 296 M persons are living with HBV and 58 M persons are living with HCV globally. In 2019, only 10% of persons living with HBV and 21% of persons living with HCV were aware of their status. Low diagnosis rates are a major barrier to reaching the global HBV and HCV elimination goals. The WHO targets aim for 65% of persons living with HBV and HCV diagnosed by 2025 and 90% diagnosed by 2030.

For each country, testing policies and implementation strategies must be tailored to the unique context to ensure elimination is programmatically and economically feasible. To improve hepatitis testing and treatment in high-burden countries, the Coalition introduced the HEAT project in 2020 to support governments in understanding their disease burden, laboratory and healthcare facility capacity, and overall testing needs to develop robust testing strategies to reach HBV and HCV elimination goals. Effective testing strategies will likely include a mix of laboratory and point-of-care based testing services, which have their own pros and cons in terms of throughput and accessibility. Ultimately, planning and implementation of the most efficient and cost-effective mix of hepatitis testing technologies is dependent on the epidemiologic situation, the current capacity for laboratory and point of-care testing, and the education and skills of clinicians and outreach workers. The HEAT project seeks to identify these effective approaches for each context.

HEAT projects have been conducted in 7 countries. Previous project partners include:

Pakistan: District Health Authority, Ministry of Primary & Secondary Healthcare – Punjab, Hepatitis Control Program- Punjab, Global Marketing Services/ Lab Diagostic Services, Municipal Medical Center Satellite Town (Red Crescent), Small Business Owners/ Trader: Restaurant Association and Sweets Association
Uruguay: Ministry of Health, National Liver Transplant Program of the Central Hospital of the Armed Forces
Malawi: Ministry of Health, Partners in Health
Nigeria: Federal Ministry of Health National AIDS and STIs Contol Program (NASCOP), West African Public Health Center and Development
Ghana: Cape Coast University, Ghana Health Service, Ghana Field Epidemiology and Lab Training Program, Hepatitis Foundation of Ghana
Moldova: National Agency for Public Health
Vietnam: Vietnam Viral Hepatitis Alliance
HEAT project activities
The HEAT project can include a range of activities that are tailored by project partners based on their analsysis of what inputs are most needed for policy and program development and what activities best bulid on previous efforts in the county/region.

HEAT activities may include:

Evaluation of hepatitis burden of disease/context: At the national or sub-national level, in collaboration with local officials, a review of the published literature, analysis of laboratory data results, and/or collection of historical testing and treatment data from clinical sites may be needed to develop a baseline description of the burden of disease, populations most affected, historical trends, and geographic distribution of disease. If the program has not conducted this assessment previously, then this analysis is necessary as the basis for developing an appropriate scale-up strategy.
Assessment of the hepatitis testing capacity [REQUIRED]: The most unique activity of the HEAT project is the assessment of the national or sub-national testing capacity for HBV and HCV. An assessment tool will be developed that evaluates if a laboratory has the a) equipment and resources required for HBV and/or HCV testing, b) what types of testing are available, c) levels of HBV and/or HCV testing currently being conducted, d) costs of HBV and/or HCV testing, e) barriers to scaling up testing, and f) opportunities for integration and testing program efficiency. Laboratory sites for assessment will be selected to include a representative sample of national or sub-national capacity. All projects must include a hepatitis testing capacity assessment.
Model the best scale-up strategy: Using the epidemiologic and testing capacity assessments as data inputs, the country/region can be added to a new web-based budget-based planning tool, the Hep C Elimination Tool. This tool was developed by Dr. Jag Chhatwal and researchers at Harvard Medical School/Massachusetts General Hospital. The tool can be used to estimate the HCV testing volumes needed to reach program targets, identify the optimal mix of laboratory-based and point of care testing as necessary to achieve these goals, estimate costs of selected scale-up strategies, and model health benefits of achieving elimination goals. A similar tool for HBV is still under development.
Update of local policies: The Coalition will assist programs in drafting updated plans and policies (i.e. national guidelines, national action plans, demonstration project protocols, and others) to reflect the required efforts for scale-up, including selecting appropriate target populations, recommending the balance of lab versus point of care platforms, establishing required annual targets, and drafting monitoring and evaluation frameworks.
Build local coalitions: If not already established, a local coalition of government health officials, clinicians, community-based organizations, and other key partners should be convened to oversee design, implementation, and dissemination of the HEAT project.
Geographic scope
The HEAT project may be implemented at the national or sub-national level, depending on the size of the country and organization of the health system.

The Coalition wishes to support hepatitis programs at varying stages of elimination planning and from diverse geographic areas.

Expressions of interest
The Coalition is now accepting expressions of interest (EOIs) for developing a HEAT project. Expressions of interest are not meant to be a full project proposal. Based on submitted EOIs, the Coalition will invite full proposals.

Questions for the Expression of Interest include:

Who will be the implementing organization for this project?
What would be the recommended geographic scope of the HEAT project- national or sub-national?
Does the national or sub-national hepatitis program have an established HBV and/or HCV elimination goal?
Are recent evaluations of HBV/HCV epidemiology available?
What are the current HBV and HCV screening policies in your country?
Have any HBV and HCV testing assessments been conducted to date?
What are the key bottlenecks to scaling up hepatitis B and C testing in your country?
How could the HEAT project help accelerate expanding testing efforts?
What activities from the HEAT project would be useful in this context?
How will the government, i.e. national hepatitis program, be involved?
What other key partners would be involved in the HEAT project?
Important factors for success include:

Demonstration of political will to initiate and actively support the evaluating of testing policies and strategies
Engagement of a broad network of local stakeholders (i.e., officials from different government Ministries, public and private organizations, patient groups of those affected by hepatitis
Support of participatory planning for elimination scale-up activities
Understanding of hepatitis program history and key local needs to improve testing
Available resources
The budget for HEAT projects is approximately USD 50,000. If expressions of interest are approved, a full project proposal with a detailed budget will be requested. The Coalition will provide technical assistance and modeling support to all projects outside of this budget.

If your program is interested in the HEAT program, please fill out this web-form by May 7th.

Photo source: Adeel Khoja, Pakistan


Page last updated: 29 March 2024
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