Let’s make hepatitis C history in Canada
What do you think of when you hear about hepatitis C? That was one of the questions posed to Canadians in an online survey we conducted this year at CATIE, Canada’s source for HIV and hepatitis C information.
Thankfully for some survey participants, there were no cash prizes for correct answers. Because we got a lot of untrue statements. No, you don’t get hepatitis C from eating or drinking contaminated food. No, there is no vaccine for hepatitis C.
In our work to increase hepatitis C awareness, our first step is often having to confront and dispel misinformation about hepatitis C risks, prevention and treatment.
HEAVIEST BURDEN
It’s understandable why these myths and misconceptions exist. There are many different forms of viral hepatitis out there. And we often hear more about hepatitis A and B when we’re making our travel preparations. But the hepatitis virus that carries the heaviest burden in Canada, in terms of impact on our health and our health-care system, is hepatitis C.
Hepatitis C is transmitted blood to blood. In Canada, it is more commonly transmitted when drug use equipment is shared. It can also be passed during pregnancy and childbirth, and in rare cases through sexual activity if blood is present. For people born outside of Canada, they may have been exposed through unsterilized medical equipment before arriving in the country.
But what makes hepatitis C most different from other viruses is that it is the first chronic viral infection with a real cure.
And this is also what sets hepatitis C apart in terms of our public health response.
REDUCING INFECTIONS
To date, eradication of an infectious disease has only been achieved twice – for smallpox and rinderpest – thanks in large part to the development of an effective vaccine. Could we make similar public health history with the first chronic viral infection with a real cure?
Epidemiologists tell us that eradicating a virus completely will not be possible without a vaccine, and developing an effective hepatitis C vaccine has proven difficult. But it is possible to reduce new infections to a point that hepatitis C is no longer a public health concern in Canada. In fact, in 2016 the Government of Canada signed on to international commitments to achieve this by 2030. Doctors, researchers, service providers and people with lived experience of hepatitis C have outlined a blueprint and a roadmap, and it is now up to federal and provincial decision-makers to implement the policies and allocate the funding to make this happen.
We have seen some progress. Canada has already achieved or surpassed two out of the three most important targets testing and treatment. We are falling significantly behind on prevention. While Canada had committed to a 30 per cent reduction in new hepatitis C infections between 2015 and 2020, by 2019 we had only reduced infections by 2 per cent. We need to achieve a 90 per cent reduction by 2030, which is only six years away.
HOW DO WE GET THERE?
• Providing greater access to harm reduction supplies so that people who use drugs are not sharing or reusing equipment.
• Encouraging more people to get tested for hepatitis C, and encouraging more doctors to offer the test to their patients.
• Adapting hepatitis C information to the languages and realities of the communities most affected.
• Approving more modern testing technologies that can offer a fingerprick test and a diagnosis in the same appointment.
• Funding communitybased health organizations to hire support workers and peer navigators to simplify access to treatment and care.
Eliminating an infectious disease as a public health concern can seem like an insurmountable task, especially when there are so few examples from history. But that is also why I tell decision-makers at all levels of government they have an opportunity to leave a legacy. Hepatitis C is the first chronic viral infection with a cure.
When it comes to health care, the rubber hits the road in the provinces. We have the tools, we just need to get them in the right hands. Which provincial government will start the trend, and become the first to make hepatitis C history?