The Australian Injecting and Illicit Drug Users League (AIVL) and Hepatitis Australia are highlighting international calls for Needle and Syringe Programs (NSPs) in prisons, along with a greater focus on harm reduction initiatives, ahead of International Drug Users Day on 1 November. The release of the Global State of Harm Reduction 20201 report reinforces calls in Australia’s current National Blood Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies2 for the implementation of NSPs in custodial settings.
“This is the first time the Global State of Harm Reduction report has included a chapter on hepatitis C,” explained Carrie Fowlie, Chief Executive Officer (CEO) of Hepatitis Australia.
“This is crucial because globally an estimated 48.5 per cent of all people who inject drugs are living with hepatitis C and more than half of the 585,000 drug-related deaths in 2017 were due to hepatitis C. Australia is reversing the trend of hepatitis C for people who inject drugs, incredibly the proportion of those living with chronic infection has declined from 51 per cent in 2015 to 18 per cent in 2019.
“The leadership from people who inject drugs is fundamental to this achievement. Australia’s hepatitis C success in this cohort is attributable to a range of factors including community education, unrestricted access to direct-acting antiviral cures, evidence-based harm reduction strategies including community needle and syringe programs, and a coordinated approach guided by national strategies delivered in partnership with affected communities, peak bodies, clinicians, researchers and governments.
According to Melanie Walker, CEO of AIVL, “The report also points out that scaling up of, and access to, harm reduction interventions – like NSP, Opioid Maintenance Treatment (OMT), naloxone distribution and community-based testing and treatment – are among key measures in decreasing the prevalence of hepatitis in international and regional guidelines. Without appropriate access to sterile injecting equipment, injecting drug use in prison poses serious health risks; according to an Australian study, syringes in prison settings are reused an estimated 100 times. There are still only 10 countries globally where this service is available.”
Ms Fowlie added that “The Global State of Harm Reduction report highlights a major blind spot in Australia’s response to hepatitis C – the ongoing failure to ensure equivalence of care in Australian prisons. Despite all Australian Health Ministers endorsing the National Hepatitis C Strategy, the commitment to improve access to NSPs for priority populations including prisoners remains unfulfilled.”
“It is also important to highlight that people who inject drugs are among the groups particularly vulnerable to COVID-19,” said Ms Walker.
“In the US, a recent review found that those with opioid use disorder are ten times more likely to contract COVID-19 than the general population, and nearly 30 per cent more likely to die from COVID-19 than other patients diagnosed with the coronavirus. Peer networks were among the first to react to the pandemic, playing a crucial role. The COVID-19 crisis has shown that harm reduction services can adapt quickly and effectively and are able to adjust service delivery and integrate innovative methods. It is important that harm reduction services are available to all people who use drugs, including those in custodial settings,” she said.
AIVL is the national organisation representing people who use/have used illicit drugs and is the peak body for the state and territory peer-based drug user organisations. Hepatitis Australia is the peak community organisation to progress national action on issues of importance to people affected by hepatitis B and hepatitis C.
Jake Docker, CEO, AIVL – email firstname.lastname@example.org
Carrie Fowlie, CEO, Hepatitis Australia 0499 775 456
1 Global State of Harm Reduction 2020
2 National Blood Borne Viruses and Sexually Transmissible Infections Strategies 2018-2022