Thank you, Presiding Officer. I really am pleased to respond to today’s debate across Members, and I thank people for the thoughtful way in which they’ve approached the issue. We, of course, recognise the importance of this issue for people right across Wales, and I’m happy to say that, together with the NHS, the Welsh Government has made major advancements in the treatment and management of viral hepatitis, a number of which have been recognised by a variety of Members across the Chamber, and I’m pleased to have the opportunity to talk about that some more today. The Welsh Government, of course, has been committed to tackling the burden of blood-borne viruses for more than a decade. We funded the blood-borne virus action plan for Wales up to 2014, and laid the foundations for the even more successful hepatology services that we now have.

When that funding was made available, it was on the understanding that health boards would invest in these services and develop the resource to prevent and treat viral hepatitis, and I really am proud that Wales has a strong and effective clinical hepatology network led, as Julie Morgan said in her introduction, by Dr Brendan Healy. That network co-ordinates the treatment of those identified with both hepatitis B and C. I want to pause there for a moment to recognise not just the work of Dr Healy but, actually, the whole network, because this is something that colleagues in England don’t have—they don’t have the same unified approach to treatment, the way in which we’re using best value treatments, both in terms of finance and outcome for the citizen, and some of the colleagues in England look on with a degree of, I wouldn’t say just envy, but they think it’s a standard and an approach to aspire to that is being pioneered and led successfully by our clinicians in Wales, and absolutely benefits the patients in so doing. It’s a model, in many ways, for services across the country—they need to collaborate and co-operate across the whole country to have a unified approach that is actually focused on improvement.

The all-Wales hepatitis C roll-out programme was initiated in 2014, and part of this is to make the best use of the new wave of more effective antiviral medication, in particular, as Julie Morgan said, interferon-free medication. That started by being initially very expensive to treat, but, actually, there’s a much longer term saving, both in financial terms, but also—mentioning my constituent Mr Thomas, who has a young family—a significant improvement in the overall well-being, not just in the medical sense, of people who receive the treatment, with quite startling cure rates for people as a result of that successful introduction. That has received both national and international recognition.

We’ve treated more than 1,000 patients in the last 18 months, and I’m proud to say we’ve now treated all of the patients who are known to services in Wales and who are still accessing care. That is a remarkable step forward made by our service. We recognise, though, that there are individuals at risk of both hepatitis B and C who do not access traditional healthcare settings, and there are numerous projects already under way in development across Wales to address this—again, recognised in the comments of people earlier in the debate on how do we get to those people who are harder to reach and don’t always access care services, either individually or even consistently. Those projects will look at ways to increase awareness of hepatitis C infection, to provide access to simpler diagnostic tests in community settings for those at risk—and, again, there’s a point here about developing and not just standing still in our service—and also to ensure that individuals who are infected are able to access treatment.

These projects, along with the all-Wales hepatitis C roll-out programme are led and guided by the Welsh viral hepatitis sub-group that Julie Morgan, again, referred to. They’re a sub-group of the liver disease implementation group—one of our, again, short, snappy titles in the world of health. But the importance of this group—and it is really important—is that it’s comprised of clinicians, nurse specialists, patient representatives, the third sector, pharmacy, laboratory staff, substance misuse services, health protection staff and Welsh Government officials. Again, that’s a feature of our approach here in Wales—genuinely taking advantage of the fact that, as a small country, we should be able to bring together the right group of people within the same room to make genuinely national choices and then expect that to be got on and delivered on a national basis. I want to thank all of those who have led on this work across all sectors and who have contributed to the very real success of the programme so far.

On 28 May last year, the World Health Assembly, the decision-making body of the World Health Organization, adopted a global health sector strategy on viral hepatitis. That strategy introduced the first ever global targets for viral hepatitis B and C control, including the goal of elimination of viral hepatitis by 2030. Achieving these targets will mean that the diagnosis and treatment of viral hepatitis is prioritised in public health services.

I am pleased to confirm again today to Members that Wales has signed up to and is committed to the World Health Organization target to eliminate hepatitis B and C. To reflect this, the Welsh viral hepatitis sub-group has amended its own term of reference to reflect the leadership and guidance that will be required from it to ensure that the elimination targets are achieved. We’ve already made huge progress against these targets, and the sub-group is developing a draft framework of actions that will be required over the coming years to achieve our goal. Officials in the Government will receive the draft framework this month. I expect them to include consideration of how to identify and test hard-to-reach groups; testing and treating in community settings; and an assurance that all those with the infection will have the opportunity to be tested and treated. The framework will provide the basis for guidance on the next steps, which will be issued to the NHS this summer.

We have what it takes here in Wales to prevent hepatitis B and C, and Wales, amongst other UK countries, has a strong preventative agenda. We have effective and targeted hepatitis A and B vaccination programmes, and the current uptake for those vaccinations is 95 per cent. From September this year, the hepatitis B vaccine will be incorporated into the routine infant programme, and all babies will be offered it at two, three and four months of age. All pregnant women are offered hepatitis B testing as part of antenatal screening, and all babies born to mothers who test positive for hepatitis B are managed according to clinical guidelines. We’re able to effectively prevent mother-to-child transmission of the hepatitis B virus through timely hep B virus birth-dose vaccination.

As Hefin David mentioned, we already have a well-established needle exchange programme in community pharmacies, ensuring access to sterile injecting equipment and effective drug dependence treatment, in order to prevent and control epidemics of viral hepatitis B and C. The majority of the current ongoing transmission of hepatitis C occurs within people who inject drugs, and we therefore prioritise the identification of individuals with hepatitis C within these communities and in providing treatment.

For those already infected, new oral, well-tolerated medicines and treatment regimens for people with chronic hepatitis C virus infection are achieving cure rates of over 90 per cent, as Julie Morgan mentioned in her remarks. And that effective treatment is also available for people with chronic hepatitis B virus infection, although for most people, such treatment needs to be lifelong. Suppressing the virus limits damage to the liver, and often it is liver damage that causes people to lose their lives. These treatments reduce the risk of long-term complications of hepatitis B and C, including cirrhosis and liver cancer. As a consequence, cost to the NHS is reduced, as these conditions are very expensive to manage. It also reduces the requirement for liver transplantation—again, a costly and complicated procedure and a resource that is in great demand. The most recent data suggest that we’re at least seeing a downward trend in liver transplants and deaths. We’re fortunate in Wales that we do have generally excellent services, with a proven expertise to lead and support these, and that those at risk can be confident that every opportunity will be taken to provide for their care. I will receive updates on progress through the viral hepatitis sub-group, and I will of course keep Members informed of this work.