Updated hepatitis C modelling in Aotearoa New Zealand: a lower burden, but clearer elimination targets.

As Aotearoa New Zealand progresses toward the elimination of hepatitis C (HCV) as a public health threat by 2030, updated national modelling provides a clearer understanding of the remaining disease burden and treatment targets. Using the Centre for Disease Analysis Foundation's Bright model, we revised earlier estimates to reflect declining incidence among people who inject drugs, treatment uptake and new seroprevalence data. The model now estimates that approximately 18,000 people were living with viraemic HCV in 2023, significantly fewer than prior estimates, but still representing a substantial public health challenge. Current treatment rates (around 450 people per year) fall short of what is needed to meet all World Health Organization targets by 2030. The model suggests that treating more than 1,300 people annually is required. While innovative approaches have expanded access for priority groups, broader general population strategies may be necessary. This recalibrated model highlights the urgency of scaling up testing, improving diagnosis and establishing operational targets to achieve elimination.