部分图像来源：全球卫生组织or Strategy on viral hepatitis 2016-2021report cover

2016年，消除丙型肝炎的目标被认为是欧洲公共卫生社区不可或缺的重点。在当年在布鲁塞尔举行的欧盟丙型肝炎政策峰会上，有100多名专家引入了HCV消除宣言。此后不久，世界卫生组织批准了first global hepatitis strategy。

这些治疗的高价可能对医疗保健系统构成重大财务挑战。但是，不采取行动的成本可能会更高。

与针对HCV解决的新兴国际共识与丙型肝炎病毒（HCV）的新型直接作用抗病毒（DAA）治疗的到来同时，解决HCV的新兴国际共识并非偶然。到2030年，这些新药首次提供了消除整个欧洲疾病的现实机会。虽然有效，但这些治疗的高价可能对医疗保健系统构成重大的财务挑战。但是，不采取行动的成本可能会更高。如果HCV未经治疗，则在许多情况下会导致肝癌和肝癌，这意味着肝移植是可用的唯一可行治疗过程。

显然，在确保消除HCV所需的大量预算时，现在该超越现金短缺的卫生部门，并考虑从一系列数组中考虑的选择融资工具已经开发出来采购其他类型的公共产品和服务。

当前的资金水平和治疗的提供水平远远不及所需的资金。

The United Nations has committed to taking urgent action to address the HCV pandemic. New treatments for HCV have the potential to be cost-saving in the long-term, provided that a sizeable and immediate investment is made in diagnosis and treatment. However, current levels of funding and provision of treatment fall well short of those required.

A2015 reportfrom the欧洲肝患者协会（ELPA）发现：‘由于缺乏或资金不足，受感染人群的很大一部分没有意识到其疾病状况。此外，在大多数国家 /地区，治疗率很低，这意味着只有一小部分被诊断为疾病的人正在接受治疗。

The practice of issuing public debt through commercial bonds is hardly novel, except where healthcare is concerned. Bonds typically have a constructive purpose and are most commonly used by governments to fund the building of bridges, roads and other infrastructure projects. Bond finance is attractive as it can be used to effectively transfer the risks associated with long-term spending commitments from governments to investors. They are an especially powerful instrument if it can be demonstrated that the spending commitment they fund is not open-ended. Through bond finance, not only can governments release money for public spending, but the maturity period can be adjusted to the timeframe in which the investment produces the desired social benefit.

尽管承认财务挑战，但欧洲的卫生服务必须找到一种赢得针对丙型肝炎的战争的方法。

在医疗保健中，我们在多个关键方面进行战斗，而乙型肝炎就是一个明显的例子。到2016年第一季度，欧盟大约有360万HCV感染，但仅诊断出120万，已经治疗了90万，而50万固化。尽管承认财务挑战，但欧洲的卫生服务必须找到一种赢得针对丙型肝炎的战争的方法。

我们知道，HCV的新疗法有可能营救数万人，从不可阻碍的游行到肝移植或死亡。这些治疗将帮助医疗保健提供者挽救生命并节省资金。即使有竞争性的药物采购和价格谈判，治疗所有患者所需的预算仍然很高。然而，我们现在未能采取行动的结果将是将负担转移给子孙后代，因为他们自己成为纳税人，选民和患者。

目前，我们有机会在15年内消除该疾病，并通过较低的HCV传播率，减少对肝脏移植的需求和较少的肝癌病例为政府节省大量。相反，尽管有建议WHO和other public health experts,clinical specialists，许多国家的政策制定者和付款人限制了接受新治疗的机会，通常是肝脏受损最严重的人。

尽管有关于谁和其他公共卫生专家，许多国家的临床专家，政策制定者和付款人的建议，但通常会限制接受新疗法的机会，通常是肝脏受损最严重的人。

健康services across the continent are under pressure, but we believe that HCV treatment through direct-acting antivirals (DAAs) should be viewed as more than in view of the high burden of chronic HCV that they could avert.

寻找过去以确定未来的潜在解决方案是有道理的。在来年，本文的合着者将合作探索HCV消除的各种选择，包括长期债券融资计划的可行性。我们想探索是否可以通过金融工程优化技术创新（例如HCV治疗）的影响。

As recently as five years ago, there was simply not enough data available for us to make this judgement. With an improved understanding of the epidemiology of HCV and the population-level impact of treatment, we can now mitigate risk for potential investors and improve outcomes for both patients and healthcare funders.

European nations have the power to transform the lives of those who need care. They can also set an important precedent for struggling health systems around the world. We have the clinical skills, and now the technology is at hand. But we need the resources to finish the job and the political support to establish innovative funding mechanisms. In HCV there is an unprecedented public health opportunity and we need to act quickly and creatively to secure the future.

Hepatology, Medicine and Policyis now accepting submissions on this and related issues. For more information, visit:www.hmap.biomedcentral.com。