Defuse the hepatitis C “time bomb”;
end the war on people who use drugs.
World Hepatitis Day is July 28th, and whilst some 500 million people globally are living with hepatitis B or C, the day barely receives any coverage, and there is a massive lack of investment in promoting awareness of this lethal virus which ultimately causes liver cancer and cirrhosis. Because hepatitis C is primarily transmitted through blood to blood contact, the vast bulk of the disease burden falls on people who inject drugs.
Some 10 million of the world’s 16 million people who inject drugs are thought to be infected with hepatitis C, yet because of a chronic lack of surveillance and testing, many are unaware that they are carrying the virus until it has wrought irreparable damage. The failure to adequately respond to this public health catastrophe, one that the WHO has called a “viral time bomb”, is very substantially driven by stigma and drug war politics. The heavy disease burden borne by the injecting community is stoked by investment in repressive responses rather than the basic preventative measures that could avert this entirely avoidable suffering and mass death. The Global Commission on Drug Policy in their recent report The Negative Impact of the War on Drugs on Public Health: The Hidden Hepatitis C Epidemic state that “instead of investing in effective prevention and treatment programmes to achieve the required coverage, governments continue to waste billions of dollars each year on arresting and punishing drug users – a gross misallocation of limited resources that could be more efficiently used for public health and preventive approaches. At the same time, repressive drug policies have fuelled the stigmatisation, discrimination and mass incarceration of people who use drugs”.
Hepatitis C is curable, new drugs coming out of development show 100% cure rates, yet a lack of political pressure to drive down prices leaves them prohibitively expensive for most people, especially in low and middle income countries where the brunt of the disease burden is borne and the legal environment for people who inject drugs is most repressive. In Eastern Europe and Central Asia some 2.3 million, and in South and South East Asia 2.6 million people who inject drugs are infected.
The same tools that can prevent HIV i.e. needle and syringe programs, opiate substitution therapy, and peer led education can also prevent HCV yet they remain woefully under invested in, and in some cases are not provided at all. Even countries that do offer needle and syringe programs do not run them to sufficient scale, have few, if any, 24 hour accessible sites, limit the amounts and types of material available, and rarely offer NSP in prisons. “The mass incarceration of people who use drugs that results from drug war politics is an unequivocal driver of HCV infection amongst our community. We need massive scale up of harm reduction programming and comprehensive peer led education”, said Eliot Albers, Executive Director of the International Network of People who Use Drugs (INPUD).
INPUD, the peak global body representing the drug using community is calling for an end to global prohibition as a necessary prerequisite for addressing this “viral time bomb”, we need a massive switch of resources from enforcement and imprisonment to proven public health measures, and an end to the war on drug users in order to defuse the ever ticking viral time bomb.
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