From pilot project to national Hepatitis C transformation
A small SPHERE investment with extraordinary reach
An early SPHERE investment in hepatitis C testing research helped launch one of Australia’s most significant public health success stories, driving national policy change, delivering tens of thousands of hepatitis C tests across the country, and attracting major follow-on funding from the Commonwealth, NHMRC, MRFF and international partners.
Supported initially by $75,000 in SPHERE Triple I funding in 2017, followed by a further $120,000 through NHMRC Partnership Grant co-funding in 2020, the TEMPO Study set out to tackle one of the biggest barriers to hepatitis C elimination: getting testing and treatment to people who inject drugs attending needle and syringe programs.
Led by Jason Grebely from the Kirby Institute, the project evaluated innovative approaches to detecting current hepatitis C infection, including point-of-care RNA testing and dried blood spot testing, compared with standard care. What began as a translational partnership project has since grown into a nationally scaled testing program, international research collaborations and a major contribution to Australia’s hepatitis C elimination efforts.
“SPHERE’s support enabled us to bring together clinical, community and policy partners to test new models of care in settings where they were urgently needed,” Professor Grebely said.
“The early funding generated the evidence and partnerships that helped drive much larger programs of research, implementation and policy impact.”
Building the evidence to change care
The early TEMPO pilot study demonstrated that point-of-care hepatitis C testing could improve linkage to treatment among a priority population while strengthening peer engagement in healthcare delivery. Those findings provided the critical evidence needed to design the larger national clinical trial that followed.
That trial became substantial in scale.
Across 16 needle and syringe program clusters spanning New South Wales, Queensland and South Australia, the TEMPO Study enrolled 1,801 participants. Results showed that the proportion initiating treatment were nearly three times higher among people receiving point-of-care RNA testing compared with standard of care or dried blood spot testing approaches.
The implications extended far beyond a single study.
Evidence generated through TEMPO, including research on patient acceptability and cost-effectiveness, directly informed the development of the Australian Hepatitis C Point-of-Care Testing Program. That national program has now delivered more than 65,000 hepatitis C point-of-care tests across 117 services and over 510 testing locations throughout Australia.
From research findings to policy and national implementation
The project’s impact has reached deep into policy, regulation and health system practice.
Findings from the program helped support the integration of point-of-care hepatitis C testing into Australian clinical guidelines, five state strategies and the national hepatitis C strategy, while also contributing to the United States hepatitis C elimination plan. Research from the program contributed to Therapeutic Goods Administration approval of a new hepatitis C point-of-care antibody test.
The project also demonstrated the power of conducting research beyond traditional hospital settings. By partnering with needle and syringe programs across New South Wales, Queensland and South Australia, the team strengthened research capability within community services while reaching populations often underserved by routine healthcare systems.
A platform for major funding success
Importantly, the project created a powerful platform for extraordinary research growth.
Since receiving SPHERE support, the work has attracted a wave of major additional funding. This includes $16.4 million from the Commonwealth Department of Health, $15.6 million from the Australian Centre for Disease Control, a US National Institutes of Health award worth more than AUD$23.6 million to conduct a related trial in the United States, a $5 million MRFF Rapid Applied Research Translation Grant, a $2.2 million NHMRC Partnership Project grant and several additional MRFF and Commonwealth-funded programs.
Reaching communities and building momentum
The program’s success has not been driven by research alone. Strong partnerships with needle and syringe programs, community organisations, health services and consumers have enabled extensive capacity building, including 184 consumer-led workshops, awareness campaigns, advocacy initiatives and demand-creation activities focused on hepatitis C testing.
Study findings have been shared nationally and internationally through major conferences and peer-reviewed publications in high-impact journals, helping amplify the program’s influence across the hepatitis field.
Professor Grebely said the project demonstrates what can happen when translational research is embedded directly within communities and health services.
“By working with community partners, health services and policymakers from the outset, we were able to build an approach that was not only effective in research settings but scalable in the real world,” he said.
“What started as a SPHERE-supported study has catalysed further work to help shape hepatitis C testing and treatment delivery nationally and internationally.”
Looking ahead
With national implementation continuing and international programs expanding, the TEMPO Study stands as one of SPHERE’s clearest examples of how early translational research investment can grow into large-scale health system change, reaching thousands of people and accelerating progress towards hepatitis C elimination.