Cascais, Portugal – September 2018
At the International Network on Hepatitis C in Substance Users (INHSU) Conference, and in partnership with the UNITE network of parliamentarians to end HIV/AIDS, viral hepatitis, and other infectious diseases by 2030, INHSU launched the Global Declaration to Eliminate Hepatitis C in People Who Use Drugs.
We are at a critical moment if we are to make progress towards the WHO global elimination targets. Morbidity and mortality from HCV infection continue to rise especially among people who inject drugs, who comprise the largest proportion of the epidemic: Globally 39% (4.6 million) of people who recently injected drugs are living with hepatitis C.
Harm reduction coverage is well below WHO recommended levels: <1% of people who inject drugs are living in countries with high coverage of both opioid substitution and needle-syringe services. Treatment restrictions and delays in registering the DAAs remain in place in the majority of countries. With the availability of the short-term, all-oral, pangenotypic cure, advocates must ramp up political pressure on governments to overcome these systemic and policy barriers and make commitments to eliminating HCV in this generation.
The key demands from the global hepatitis C community are to call on political leaders to:
1. Commit to advocate for improved access to harm reduction services;
2. Pledge to promote, support, and strive for more health services that are accessible and acceptable to people who use drugs;
3. Agree to push for global removal of access and reimbursement restrictions to hepatitis C therapies based on recent or ongoing drug use;
4. Commit to support the negotiation of better prices for diagnostics and treatments;
5. Pledge to eliminate stigma, discrimination, and violence against people who use drugs;
6. Commit to advocating for drug policy reform to decriminalize drug use and possession, and reduce the incarceration of people who use drugs
7. Advocate for enhanced funding for hepatitis C elimination efforts.
The hepCoalition supports the Declaration and urges our network to sign on. The hepCoalition will continue to work on HCV elimination efforts that prioritize drug decriminalization and scaling up of harm reduction services (including in prisons) — which includes safe consumption spaces — as these are essential for people who use drugs. The hepCoalition understands that the pharmaceutical industry needs to be engaged in elimination efforts, yet we continue our vigilance of their extortionate drug pricing, push to hold them accountable for their abusive patenting practices, and advocate for countries to implement intellectual property flexibilities, which we emphasize as critical to increase access to affordable treatments and diagnostics.