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Cherokee Nation’s Push to Eliminate Hepatitis C
Cepheid 

Cepheid 

Équipe de rédaction

Visionnement de 6 m

24 juillet 2026

LA SANTÉ COMMUNAUTAIRE ET MONDIALE

Histoire d’impact

Inside the Cherokee Nation’s Push to Eliminate Hepatitis C

In the heart of the Cherokee Nation, a new approach to healthcare is changing how communities access hepatitis C care.

A key part of the service here in northeastern Oklahoma is a mobile clinic that feels more like a welcoming home than a traditional medical facility.

“It’s a place that doesn’t feel sterile or clinical,” says Coleman Cox, a Clinical Supervisor in the Cherokee Nation Harm Reduction Program. “We wanted it to feel like a nice place you’d like to come and sit for a bit, cool off, and gather yourself.”

This unconventional setting is part of a broader push to tackle hepatitis C – a major public health burden across the United States that falls heaviest on communities struggling with injection-drug use. The Cherokee Nation has felt the impact of the opioid crisis acutely.

For years, distance, stigma, and fragmented care have allowed the virus to persist. Now, a shift is underway. In June 2024, the FDA approved Cepheid’s Xpert® HCV test,1 enabling mobile, point-of-care testing and same-day diagnosis and treatment.

For healthcare professionals working in community settings, the ability to diagnose and treat hepatitis C quickly and efficiently is critical, making on-the-spot care possible for those who need it most.

Learn more and watch the video: 

The Challenge: Reaching the Most Vulnerable

The reservation covers some 7 000 square miles, and many of its 141 000 residents live in remote, rural areas where transport is limited and healthcare services are often out of reach. Even for those who can access traditional hepatitis C care models, many are lost between initial screening and confirmatory testing or treatment initiation.

"The key is going to places where people need us rather than waiting for them to come to us," says Dr Stephen Jones, CEO and Executive Director of Cherokee Nation Health Services.

Strict laws in Oklahoma had blocked syringe-service programs. Once legalized in 2022, such programmes created a vital point of contact for reaching vulnerable people at risk of hepatitis C infection.

Screening for hepatitis C infection the virus began in earnest, but only around half of people who tested positive for hepatitis C antibodies at syringe-service sites returned for confirmatory RNA analysis. Fewer still came back for treatment.

“The people least likely to come back were those who were most vulnerable,” says Dr Jorge Mera, Director of Infectious Diseases for Cherokee Nation Health Services. This hindered attempts to eliminate the disease. In 2016, the World Health Organization declared global targets to eliminate hepatitis C as a public health threat, aiming to reduce new infections by 90% by 2030.2 The goal became realistic with the arrival of highly effective oral antiviral agents in 2014.

“When you’re looking at WHO- or CDC-level elimination goals, a 90% reduction is the magic number,” Mera says, “but the 10% left out is going to be the most vulnerable. In our minds we need to reach 100% of that population so that no community member gets left behind.”

Point-of-Care Testing Technology Closes the Loop

The FDA authorization of the Xpert® HCV test eliminated the need to wait weeks or months between appointments, a time when many were lost to follow-up. Cherokee Nation Heath Services deployed GeneXpert® systems already used for COVID-19, RSV, and influenza testing to deliver timely hepatitis C RNA testing in a single visit in mobile and community clinics.

Early results have been remarkable. Mera says that “70–80%3 of the patients who have tested positive in the harm reduction site have initiated treatment. And that, for us, is amazing because these patients, probably, we would never have seen in the clinics.”

“We can say to people today you can get started on treatment,” adds Cox. “You don't have to wait. You don't have to walk away and live in fear. Today is the day that you can move forward and get healthier."

A Model for Others to Follow

The Cherokee Nation’s approach allows them to meet patients where they are – both physically and in life. Support workers care for the whole person, says Cox, body, mind, and spirit, whether or not someone is ready to stop using drugs.

Encouraged by the results, the Cherokee Nation want to roll their model out further. They plan to expand access in mobile units for rapid, same-day testing for multiple infections and to partner with jails for testing those incarcerated.

With all this in motion, Dr Mera believes elimination is within reach – and soon. “We're on the right track and with the right support, we have a good shot at eliminating it,” he says.

It’s an ambitious goal, but one that finally feels within sight.

 

Clinical Impact: What Health Care Professionals Need to Know

Rapid Diagnosis and Treatment Integrated in the Community:

Point-of-care testing may help reduce barriers in the hepatitis C care pathway, enabling clinicians to treat patients who might otherwise be lost to follow-up.

High acceptance:

Patients responded positively to same-day care, especially when delivered in non-traditional, supportive settings.3

Potential to Scale up:

The Cherokee Nation plans to expand point-of-care testing to mobile units and correctional facilities, demonstrating the model’s adaptability.

Lessons Learned: Overcoming Barriers

Staff Training:

Comprehensive training was essential to ensure accurate testing, counselling, and linkage to care.

Patient Engagement:

Building trust and reducing barriers increased acceptance of testing and treatment.3

Collaborate Across Sectors:

Partner with public health, harm reduction, and correctional programs to maximize reach.

Références :

 

1. FDA Permits Marketing of First Point-of-Care Hepatitis C RNA Test | FDA. June 2024

2. Organisation mondiale de la Santé. Élimination de l’hépatite d’ici 2030. Access July 2026.

3. Described in the Cherokee Nation Health Services video.

 

Avis de non-responsabilité : Le contenu présenté sur cette page est destiné à des fins informatives et éducatives. Bien qu’il soit disponible à l’échelle mondiale, il peut refléter des pratiques cliniques ou des enjeux en matière de système de santé propres à une région particulière.

 

IVD. Dispositif médical de diagnostic in vitro. Pourrait ne pas être disponible dans tous les pays.

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