Blueprint for Hepatitis C Elimination in Canada: A priority populations and health equity approach – Part Two

This blog post is a follow-up from an earlier post published on August 27, 2019 about the Blueprint to Inform Hepatitis C Elimination Efforts in Canada. 

People who use drugs

By Jennifer Broad, Toronto Community Hep C Program

As someone with lived experience of HCV and who works as a community support worker in a program for people who use substances, I am pleased with how the Blueprint prioritizes people who use drugs in its response to hepatitis C elimination. I am also encouraged by the intersectional and health equity approach that the Blueprint takes in promoting a holistic view of people who use drugs, one that acknowledges the need to address issues beyond drug use, like mental health, criminalization, homelessness and poverty.

Harm reduction services are often the only or first point of healthcare contact for people who use drugs and other marginalized people, many of whom may have had negative or stigmatizing experiences in mainstream healthcare settings. The integration of harm reduction principles and practices throughout this document highlights its critical role in elimination. The Blueprint even calls for the decriminalization of drug use as a policy and service delivery recommendation, something that I feel very strongly about. I would even argue that decriminalization is just the first step and that we must go further by offering a safe supply of all types of illicit drugs.

Equally as significant are the sections where the Blueprint acknowledges and validates the multiple forms of stigma faced by people who use drugs as a significant barrier to HCV diagnosis, treatment and care. People who use drugs often don’t speak about these experiences, but addressing the presence of stigma in our health and social service systems would go a long way in increasing care engagement. The Blueprint offers some suggestions for how to do this, such as making sure people who use drugs are meaningfully engaged in program design and delivery. Peer engagement, in my opinion, is an often-overlooked component of hepatitis C programming, but so important if we are to be successful in our elimination goals.

People with experience in the prison system

By Sandra Ka Hon Chu, Canadian HIV/AIDS Legal Network, and Lindsay Jennings, Prisoners HIV/AIDS Support Action Network (PASAN)

All too often, policymakers have had the tools to address a public health threat, but lacked the political will to set the wheels in motion. This is certainly true of hepatitis C. Although HCV can be both prevented and cured, it has been described as Canada’s “most burdensome infectious illness” because it still leads to more years of life lost in Canada than any other. Prompt action is thus critical to prevent the ongoing spread of HCV and to treat all those living with HCV. The authors of the Blueprint seek to bridge the gap between evidence and action. It was launched to provide federal, provincial and territorial governments with options to address HCV in Canada.

This is an important resource for advocacy organizations such as the Canadian HIV/AIDS Legal Network and PASAN, who advocate for the human rights of marginalized communities, many of whom are living with, at risk of, or affected by HCV. The Blueprint provides concrete targets in the areas of HCV prevention, testing and diagnosis, and HCV care and treatment — targets which offer essential reference points for organizations such as ours, as we push for change. At the same time, policy and service delivery recommendations that address stigma, encompass harm reduction, and include specific recommendations for priority populations, such as people who inject drugs, Indigenous people and people in prison, will equip us to more effectively advocate for greater access to HCV treatment, harm reduction services and drug treatment options for these neglected communities. More broadly, these recommendations also support our calls for the decriminalization of drug possession for personal use. With the Blueprint in hand, the ball is now in government policymakers’ court to meaningfully address HCV so the virus becomes an infection of the past.

The Blueprint was launched this past May, but it’s just the beginning and the real work starts now. The Blueprint is meant to be a guide for each province, territory and the federal government to develop and carry forward an action plan for hepatitis C within their jurisdiction. I hope it proves to be a useful tool, keeping us on track and ensuring we progress collectively towards the ambitious goal of hepatitis C elimination by 2030.