In a major boost to harm reduction efforts, global health agency Unitaid yesterday announced a $31 million commitment to preventing hepatitis C among people who inject drugs and other at-risk populations such as people in prisons. The prevention tools and approaches will also help prevent transmission of other blood-borne diseases including HIV.
Breakthrough advances in recent years have made hepatitis C treatment highly effective and affordable in most low- and middle-income countries. However, limited awareness and insufficient access to care severely hinder efforts to eliminate the disease, particularly amongst communities where rates of transmission are the highest.
Though people who inject drugs represent just 10% of the 58 million people infected with hepatitis C worldwide, injection drug use contributes to 43% of all new infections.
Unitaid’s funding will support the integration of hepatitis C testing and treatment within harm reduction programs and trial the use of two products to prevent infection: low dead space syringes and new, long-acting formulations of buprenorphine, a medicine used in opioid agonist therapy.
Low dead space syringes have a smaller reservoir where blood can remain after use, which limits the risk of transmitting blood-borne infections when needles are shared. Slow-release formulations of buprenorphine, a medicine that reduces opioid cravings and withdrawal, could provide a valuable option for clients who face challenges with daily doses of the oral formulation, such as high out-of-pocket expenses, police harassment, or discrimination.
Karin Timmermans, Senior Technical Manager at Unitaid, speaking at the 27th Harm Reduction International Conference in Melbourne said that Hepatitis C is becoming increasingly relegated to neglected populations that are too often overlooked by global health responses and Unitaid is proud to step up in support of harm reduction approaches to treat and prevent hepatitis C among people who face the greatest barriers to care.
Judy Chang, Executive Director of the International Network of People who Use Drugs (INPUD) also said they welcome Unitaid’s commitment to preventing hepatitis C through harm reduction approaches and, importantly, for centering meaningful community involvement from its inception. Funding community-led research and advocacy on the best approaches to prevent and treat hepatitis C is an important step towards promoting a more equitable health landscape and they look forward to working with Unitaid and partners to ensure their voices and perspectives are heard and represented.
Implemented through three complementary projects in a total of ten countries, Frontline AIDS, Médecins du Monde, and PATH will work to ensure people at greatest risk are aware of the need for hepatitis C testing and have quick and easy access to treatment.
The projects will also generate evidence critical to enabling the broader use of low dead space syringes and long-acting buprenorphine, including understanding user preferences, addressing high costs, increasing demand, and demonstrating effective delivery.
This latest initiative builds on a longstanding commitment from Unitaid to address hepatitis C. Previous support has helped drive down the cost of services, simplify screening and diagnosis, demonstrate effective delivery strategies to reach at-risk populations, and increase awareness.
