Introduction – Given the global goal of eliminating hepatitis C virus (HCV) by 2030, the objective was to assess the impact of public policies and the COVID-19 pandemic on HCV screening and treatment initiation with direct-acting antivirals (DAAs). Methods – Individuals living in mainland France with at least one reimbursed HCV test and those who initiated DAA treatment between January 1, 2014, and December 31, 2021, were identified using the National Health Data System. Results – Between 2014 and 2021, 25.045 million people were tested. The annual number of people tested increased by 5% between 2014 and 2017 and by 9% between 2017 and 2019, before decreasing (-8%) in 2020, particularly in April (-55% compared to February), coinciding with the first lockdown related to the COVID-19 pandemic, before rebounding in 2021 (+9%), reaching 3,633 million. The number of AAD initiations was 96,776 over the 2014–2021 period. The quarterly number of patients initiating treatment increased starting in the first quarter (Q1) of 2014 (n=1,615), more markedly in Q1 2015 (n=3,960), when access to DAAs was prioritized and Harvoni® became available, and then in Q1 and Q2 2017 (>5,000), coinciding with the recommendation for universal access and the availability of Zepatier® and Epclusa®. Quarterly figures then declined through Q3 and Q4 2021 (approximately 1,300). In 2020, a 66% decrease was observed in April compared to February. Conclusion – Since mid-2017, the number of DAA initiations has been declining, despite measures to improve access and increased screening, suggesting a dwindling pool of people requiring treatment. Further efforts are needed to eliminate hepatitis C in France.