As the HepHIV 2014 Conference in Barcelona continues, guest blogger Professor Jeffrey Lazarus tells us about the challenges we face to combat hepatitis in Europe.

When is it important to gather more evidence to inform the response to a major public health problem, and when must we act on the limited available evidence in order to save as many lives as possible? As I worked with my colleagueKevin Fentonto prepare a supplement published byBMC传染病onviral hepatitis and drug use in Europe，，，，I found myself reflecting often on this question.

It weighed on my mind in part because of the scale of the problem: the World Health Organization European region has an estimated 15 million people living with the hepatitis C virus (HCV), and two million of these people are thought to be current injecting drug users. The practice of sharing injecting drug equipment is widely recognised to be one of the key drivers of Europe’s hepatitis C epidemic today.

There is a need for swift action to fill a policy and programmatic void in many European countries regarding viral hepatitis prevention and treatment services for people who inject drugs. Growing recognition of this situation has helped to catalyse widespread interest in the first欧洲丙型肝炎和吸毒会议，，，，slated for 23-24 October 2014 in Berlin.

We anticipate that many of those people who attend or follow the conference will find themselves grappling with a common challenge in its aftermath: how to move forward, whether on HCV prevention, treatment, surveillance, advocacy or other fronts, when there are so many gaps in the body of evidence that should be guiding us.

例子：评论文章我合着了这项补充。该文章研究了在欧洲注射药物的人中的HCV治疗摄取水平。从一项研究到另一项研究，诸如药物使用，HCV治疗的资格以及应启动治疗的标准之类的关键因素，以使我们不愿意对毒品的程度进行任何宣传的声明。患有丙型肝炎的使用者正在接受治疗。

For studies reporting on treatment uptake levels among当前的注射吸毒者 - 从疾病控制和人权的角度来看，这是一个关键问题 - 我们审查中包括的25项研究中只有一项提供了此信息。但是，如果有人问我有多少人在欧洲地区正在接受治疗的丙型丙型肝炎，我会强调地回答：“还不够。我们需要对此做些事情 -now。”

In other words, wrinkles will need to be ironed out of the evidence base before we can confidently put forth a HCV treatment uptake level for drug users that seems relatively precise. But do we really need a number in order to intensify advocacy efforts on behalf of those who need treatment?

无论是30％还是更高的比例，几乎每个在该领域工作的人都会同意，注射毒品的人更容易获得HCV治疗是一个关键的倡导和公共卫生目标。

不幸的是，我们目前对注射毒品的人面临的健康问题的许多方面的了解受到限制，这种方式有可能破坏该人群中对HCV流行的欧洲范围内反应的发展。

那么，该领域的决策者应如何确定是否仅仅采用可用证据支持的策略来推动策略呢？对于这种特定于上下文的问题，没有简单的公式化答案。但是，我从欧洲的病毒性肝炎和药物使用的配合补充剂中学到的东西是，在此过程中，重要的是要涉及各种选区的声音。

I already would have taken that stance on principle; what strikes me now, after working closely with many of the supplement authors over a period of a year, is just how much wisdom and experience the community has to share.

I use the word “community” broadly in this instance, not to refer only to community-based organisations or civil society actors, but rather to the entire community of people who are increasingly drawn together by their shared outrage about societal neglect of people who inject drugs.

This community includes researchers, policy-makers, advocates, activists, programme implementers, and those PWID who are reaching out to all of the rest of us in an urgent attempt to make their needs better understood.

可以从实证研究和生活经验中得出的这个社区见解的几个令人印象深刻的例子，可以找到in the aforementioned supplement。当我参加2014年10月23日至24日的柏林欧洲HCV倡议会议时，我非常期待进一步惊叹。

Professor Jeffrey V. Lazarusis the Secretariat Director of Health Systems Global and a Senior Researcher at CHIP, the Centre for Health and Infectious Diseases Research and a WHO Collaborating Centre, at Rigshospitalet, the University of Copenhagen.