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1. Viral Hepatitis - A National Perspective: Closing the Gaps

I really want to thank the NVHR organizing committee for getting us here today and giving me the opportunity to talk to you about a number of issues including where we think we ought to be heading in terms of eliminating and preventing this scourge that has occurred in the United States and globally. Yes I come from the CDC perspective, but hopefully I will offer a national perspective in terms of where I think we ought to be going - and I really bring this from other government agencies, the NIH, the FDA, HRSA, all of the state and local health departments and agencies that are currently trying to deal with these diseases and infections, from all of you from advocacy groups in terms of what you have been doing, as well as from academia, people who have been putting together data and information that I will present today. I have also had the wonderful opportunity to work with my colleagues in my own division, people who have put together much of this information, which I then have the opportunity to present to you - we have our debates and discussions and hopefully use this to build direction. What I am going to try to do this morning is give you a framework - I am not going to include everything, I don't have enough time. Yes, I have certain biases - I bring the bias of prevention, but I hope what I'll show you is that my view of prevention is all the way from primary prevention to treatment and care and all of the pieces that go into eliminating these diseases, these infections, as well as eliminating the pain and suffering that they produce in the populations that we serve. I am very much driven by an evidence-based foundation, and I hope that as we as a group work together over the years that we always use this as our underpinning. Yes, we then have to become practical, to turn this into practice, but we always seem to do best if we have something that underpins it and that we can go back to and say, "yes, this is the best information." But, it's also important that we figure out the gaps, both in information as well as where we are in terms of implementation. The other thing I would like to bring this morning is that I think we have taken a new view, and I can tell you that personally I have taken a new view. Since yesterday, I have been talking about elimination, prevention, and control of viral hepatitis, and I have come to the point where we now look at this as an entity, as almost a single entity. But it is extremely important that we continue to work on each of the agents, so that we get better vaccines and better treatments - because they don't cross, these are different problems. They have their own life and their own way of approaching things, and we have to figure that out in order to take care of them. But when we bring them together in terms of prevention, I think that is a new perspective that the NVHR and those of us working in the field have begun to take. So I think that is something else I would like to bring.