Elimination of hepatitis C in Australia at risk due to COVID-19

While Australia is on track to become one of the first countries to eliminate hepatitis C, which is part of the World Health Organization’s (WHO) global goal to eliminate the infectious disease as public health threat by 2030, the COVID-19 pandemic is putting elimination goals at risk.

The ongoing COVID-19 pandemic and the related measures it has taken to curb infection rates have impacted drug use, drug and hepatitis C treatment services, and the health of people who use drugs, increasing the risk of new hepatitis transmission.

Recent research by the National Drug and Alcohol Research Centre (NDRAC), which looked at 702 people who used drugs during COVID-19 restrictions and lockdown, shows that only 24% were able to avoid sharing drug injecting equipment.

In light of this, Australia’s leading drug and infectious disease organisations will join forces to call for a re-engagement in elimination of hepatitis C in an online event on World Hepatitis Day on Tuesday 28 July 2020.

“Hepatitis C is a blood borne virus and people who inject drugs are a crucial priority population,” says Hepatitis Australia CEO, Carrie Fowlie.

“Not only is there a risk that the WHO 2030 elimination goal could be set back, but more immediate negative impacts could be experienced by people at risk of contracting hepatitis or seeing hepatitis treatment in Australia due to current and future social, health and policy changes.”

Australian Injecting and Illicit Drug Users League (AIVL) CEO, Melanie Walker adds that some of the new regulations and social requirements are impossible for drug users to abide by.

“People who use drugs need to attend and syringe programs (NSPs) and be able to have ongoing access to the full range of harm reduction, pharmacotherapy and other drug and hepatitis treatments,” says Ms Walker.

“If people who use drugs cannot access these services, we could see an increase in sharing of injecting equipment, which could lead to increased cases of hepatitis C and compound the negative health outcomes already experienced by this group.”

While according to the 2019 National Drug Strategy Household Survey, illicit drug use is responsible for 75% of Australia’s acute hepatitis C burden of disease, Head of Viral Hepatitis Clinical Research Program at the Kirby Institute, UNSW, Sydney, Professor Greg Dore points to recent data from the Australian Needle Syringe Program Survey, which reveals that hepatitis C infection in people who inject drugs has declined from 51% to 18% between 2015 and 2019.

“Despite these declines … continued declines in numbers being treated through 2019 and into 2020 compromises the achievement of WHO elimination goals,” he says.

“More strategies are needed to raise awareness of the need for testing and availability of new hepatitis C treatments to eliminate hepatitis C by 2030.”