We acknowledge this Land was never ceded, that it always was, and always will be, Aboriginal Land.
Hepatitis SA supports the establishment of an Aboriginal and Torres Strait Islander Voice to Parliament in the Australian Constitution. A constitutionally enshrined Voice to Parliament will give Aboriginal and Torres Strait people a say on issues that affect their lives.
Hepatitis SA Chief Executive Officer, Kerry Paterson, said the trauma of colonisation and racist government policies over generations have resulted in excessive socio-economic disadvantage for Aboriginal and Torres Strait Islander people.
“Aboriginal and Torres Strait Islander people are over-represented in the communities we serve including those in the criminal justice system, drug and alcohol services and those affected by viral hepatitis,” she said. “Decades of effort by governments to address the disparity has not closed the gap.
“The Voice to Parliament is a proposal from the Aboriginal and Torres Strait Islander people themselves.
“We believe it is not controversial for governments to inform their decision-making by listening to experts. The experts on issues affecting Aboriginal and Torres Strait communities are leaders of Aboriginal and Torres Strait Islander people.
“A constitutionally protected Voice to Parliament provides a permanent channel of advice to government through which Aboriginal and Torres Strait Islander people can have real input into decisions affecting their communities.
“We urge our members to make an informed choice in the Referendum on 14 October.
“If you don’t know, find out.”
READ MORE:
voice.gov.au (also available in other languages)
ulurustatement.org
www.yes.org.au
www.sacoss.org.au/campaign/main-site/uluru-statement-and-voice-referendum
www.aec.gov.au/referendums
Authorised by K Paterson, Hepatitis SA, 3 Hackney Road, Hackney SA 5069
This was the first Harm Reduction Conference since 2019 and everyone was excited to hear what Australia had been doing as an early adopter of health-based approaches to drug use. I wanted to hear about what was going on in the Southeast Asian region, as they are our closest neighbours and notoriously hard-line on drug users, with alarming rates of incarceration of women and the use of death penalties for drug offences. Sadly, most of the would-be attendees from Southeast Asia were not given visas.
The conference went for three days: each day we had about 30 presentations to choose from. It was mind-boggling. I would choose something and then question whether I had made the right choice. Most of the presentations I saw were about peers or civil disobedience, focusing on people who had made the choice to do something that was illegal but ethically right. For instance, in Dublin a small organisation had bought a van, which they would park in an alleyway at a certain time of day. This van was an injecting room. Dublin had people injecting and overdosing in the street, so if they could inject safely in a van with a couple of people around them and naloxone on hand, isn’t that a good thing? The police would come and ask them to open up, which they would do after the person had injected the drugs. The police could do nothing as the drugs were gone. Of course, police don’t like this kind of thing and pursued the van with a vengeance. One staff member ended up being arrested and charged for not unlocking the van and for obstructing police. He went straight back out the next day. Often their clients were in wheelchairs and needed to be lifted in and out of the van, which was not an easy feat. This van led to changes for injecting drug users in Dublin. The power of people is enormous.
Thinzar Tun from Myanmar’s presentation was called “If there is a will there is a way!—A peer-led Women’s Cost Effective Service Delivery in Rural Areas of Myanmar”. Drug-using women in Myanmar are discriminated against and looked down upon. They struggle to get through each day with no money, no transport and no support from anybody. They paid peer workers to ride motor bikes into rural areas to meet female drug users where they wanted to be met: in shooting galleries, in brothels, and on the street. There they helped them with day-to-day things such as medical appointments and picking up their methadone supplies.
This project helped 194 women in the first year. The cost for each peer, with a bike, was only $37 per year—such a small amount of money to increase women’s quality of life. The only question I had for Thinzar Tun was why did they only employ male peers? Perhaps it had something to do with the funding, or maybe they were the only drug users they could hire.
Most of the presentations I saw were from countries that have a huge opioid problem, such as Canada, the US and the UK. As drug users are dying by the thousands, the governments and the communities look the other way when people try to do something to ease the pain of all of these deaths, such as having a shop in Canada to sell quality-tested drugs openly to people. As always, effective harm reduction is the only way forward.
Australia is in a different position, as methamphetamine is the favoured drug here. We don’t have massive amounts of opioid deaths, though some people want you to think we do. Sadly, Australia is lagging hopelessly behind and I honestly think people attending the conference might have been disappointed with what we have been doing in the harm reduction and peer space.
I met so many amazing people at this conference, from Canadian drug users to Norwegian nurses. Each and every one of them has a passion for harm reduction and helping the most stigmatised communities in the world. After three days I was exhausted but happy.
Notes from Meagan …
I was lucky enough to attend HR23 this year, it’s the first time I’ve attended anything like that before and found it to be a great opportunity to network with people from other organisations as well as hear about what’s going on in the world of Harm Reduction. I especially liked meeting the workers from Harm Reduction Victoria and loved the display they had set up!!
In one of the sessions the EC campaign was mentioned and as Penni and I were involved in promoting it in the city centre last year I was wrapt to hear it had been one of the most successful campaigns thus far.
I also heard several speakers talk about their harm reduction efforts in countries such as Myanmar and couldn’t help but think that they’ve really got their work cut out for them. After that I’ll never complain about having to get up for work again…. Well maybe just a little….
]]>The Harm Reduction conference is held in a different country every two years and provides a forum for sharing the latest research, programs and policy in drug use, harm reduction* and human rights. The conference is convened by Harm Reduction International (HRI) – an organisation that promotes harm reduction and rights-based, evidence-based responses to drug use.
What I like about the HRI conference is that HRI always works in partnership with the local Drug User Organisation or peer program to facilitate drug users’ participation in the conference. As the conference was held in Melbourne this year, the local peer-based organisation Harm Reduction Victoria co-hosted the conference.
Awards were given out at the Opening Ceremony, and the inaugural Gill Bradbury Award (awarded to an individual, group or organisation providing excellent services to people who use drugs) went to the AIVL National Peer Network, of which the Hepatitis SA CNP Peer Projects is a member. It was great to see peers’ contribution to harm reduction acknowledged on an international level.
This year the overarching themes were drug law reform (decriminalization of small quantities of drugs for personal use and/or the sale of small quantities of drugs ie ‘user dealers’) and ‘safer supply’, as a result of the tragic impact of fentanyl and its analogues. Fentanyl and fentanyl analogues have contributed to the deaths of many tens of thousands of people in the US and Canada. I can only be thankful that fentanyl has not made huge inroads into the Australian supply but I believe that we must have our SA response prepared if/when it does.
The conference presentations and panel discussions were enlightening but it is the opportunities for networking and sharing experiences that I will remember for longer. I was inspired by hearing about civil disobedience and what’s happening on the ground to improve the lives of people who use drugs.
I participated in the workshop to develop the Conference Declaration, which was read out at the closing ceremony. The Melbourne Declaration advocates for the genuine inclusion and representation of people who use drugs, demands equitable health and social outcomes and an end to criminalisation and prohibition of drug use.
*Harm reduction refers to policies, programmes and practices that aim to minimise the negative health, social and legal impacts associated with drug use, drug policies and drug laws. Harm reduction is grounded in justice and human rights. It focuses on positive change and on working with people without judgement, coercion, discrimination, or requiring that people stop using drugs as a precondition of support.
]]>The liver is known for its ability to regenerate (see last issue’s cover story for more information). It can completely regrow itself even after two-thirds of its mass has been surgically removed. But damage from medications, alcohol abuse or obesity can eventually cause the liver to fail. Currently, the only effective treatment for end-stage liver disease is transplantation.
However, there is a dearth of organs available for transplantation. Patients may have to wait from 30 days to over five years to receive a liver for transplant in the U.S. Of the over 11,600 patients on the waiting list to receive a liver transplant in 2021, only a little over 9,200 received one.
But what if, instead of liver transplantation, there was a drug that could help the liver regenerate itself?
I am the founding director of the Pittsburgh Liver Research Center and run a lab studying liver regeneration and cancer. In our recently published research, my team and I found that activating a particular protein with a new medication can help accelerate regeneration and repair after severe liver injury or partial surgical removal in mice.
The liver performs over 500 key functions in your body, including producing proteins that carry fat through the body, converting excess glucose into glycogen for storage and breaking down toxins like ammonia, among others.
Liver cells, or hepatocytes, take on these many tasks by a divide-and-conquer strategy, also called zonation. This separates the liver into three zones with different tasks, and cells are directed to perform specialized functions by turning on specific genes active in each zone. However, exactly what controls the expression of these genes has been poorly understood.
Over the past two decades, my team and other labs have identified one group of 19 proteins called Wnts that play an important role in controlling liver function and regeneration. While researchers know that Wnt proteins help activate the repair process in damaged liver cells, which ones actually control zonation and regeneration, as well as their exact location in the liver, have been a mystery.
To identify these proteins and where they came from, my team and I used a new technology called molecular cartography to identify how strongly and where 100 liver function genes are active. We found that only two of 19 Wnt genes, Wnt2 and Wnt9b, were functionally present in the liver. We also found that Wnt2 and Wnt9b were located in the endothelial cells lining the blood vessels in zone 3 of the liver, an area that plays a role in a number of metabolic functions.
Eliminating the two Wnt genes from endothelial cells also completely stopped liver cell division, and thus regeneration…
To our surprise, eliminating these two Wnt genes resulted in all liver cells expressing only genes typically limited to zone 1, significantly limiting the liver’s overall function. This finding suggests that liver cells experience an ongoing push and pull in gene activation that can modify their functions, and Wnt is the master regulator of this process.
Eliminating the two Wnt genes from endothelial cells also completely stopped liver cell division, and thus regeneration, after partial surgical removal of the liver.
We then decided to test whether a new drug could help recover liver zonation and regeneration. This drug, an antibody called FL6.13, shares similar functions with Wnt proteins, including activating liver regeneration.
Over the course of two days, we gave this drug to mice that were genetically engineered to lack Wnt2 and Wnt9b in their liver endothelial cells. We found that the drug was able to nearly completely recover liver cell division and repair functions. Lastly, we wanted to test how well this drug worked to repair the liver after paracetamol overdose.
Paracetamol, or acetaminophen, is an over-the- counter medication commonly used to treat fever and pain. However, an overdose of paracetamol can cause severe liver damage. Without immediate medical attention, it can lead to liver failure and death. Paracetamol poisoning is one of the most common causes of severe liver injury requiring liver transplantation in the U.S. Despite this, there is currently only one medication available to treat it, and it is only able to prevent liver damage if taken shortly after overdose.
…one dose was able to decrease liver injury biomarkers … in the blood and reduce liver tissue death.
We tested our new drug on mice with liver damage from toxic doses of paracetamol. We found that one dose was able to decrease liver injury biomarkers—proteins the liver releases when injured— in the blood and reduce liver tissue death. These findings indicate that liver cell repair and tissue regeneration are occurring.
One way to address liver transplantation shortages is to improve treatments for liver diseases. While current medications can effectively cure hepatitis C, a viral infection that causes liver inflammation, other liver diseases haven’t seen the same progress.
Because very few effective treatments are available for illnesses like nonalcoholic fatty liver disease and alcoholic liver disease, many patients worsen and end up needing a liver transplant.
My team and I believe that improving the liver’s ability to repair itself could help circumvent the need for transplantation. Further study of drugs that promote liver regeneration may help curb the burden of liver disease worldwide.
– Satdarshan (Paul) Singh Monga, Professor of Pathology and Medicine, University of Pittsburgh
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Worldwide, someone dies from hepatitis-related illness every 30 seconds. In Australia, hepatitis is a leading cause of liver cancer which is the fastest growing cause of cancer deaths. Delays in acting on hepatitis during the pandemic was confirmed by the Doherty Institute WHO Collaborating Centre for Viral Hepatitis which reported a 20% drop in hepatitis testing in 2020, compared to the same time in 2019.
There is a safe and effective vaccine against hepatitis B. For people who are living with the virus, regular monitoring will ensure timely treatment that will help to keep the virus in check and prevent serious liver disease.
A quarter of the 220,000 people in Australia with chronic hepatitis B are undiagnosed and therefore not receiving any care. More worrying is the fact that only one in five of these people are in medical care. The expert advice is for all people with chronic hepatitis B to receive regular monitoring and timely treatment as needed. We are nowhere near the conservative national target to have half of people with chronic hepatitis B to be in medical care by the end of next year.
In South Australia, there are over 12,000 people living with hepatitis B and an estimated 3,000 of these people are unaware of their infection. Less than 1 in 5 South Australians with chronic hepatitis B are receiving medical care and only 1 in 20 are on treatment. This is a long way off from the national targets of getting half of all people with hepatitis B into ongoing care and 1 in 5 on treatment.
Not everyone with chronic hepatitis B needs to be on treatment, but experts estimate that about a quarter will need to be on antiviral therapy to minimize adverse outcomes. Without regular and timely medical care, hepatitis B can lead to liver failure or liver cancer.
In 2018, there were more than 400 hepatitis B-related deaths in Australia. Hepatitis SA is urging the community not to wait, to take action to stop hepatitis B.
Get tested. Get the right care. Don’t wait.
Hepatitis C treatment uptake in South Australia is above the national average. Yet 8,000 South Australians still unnecessarily live with the life-threatening disease that can be cured in 8 or 12 weeks. Nationally, that number stands at 120,000.
Highly effective Direct-acting Antivirals (DAAs) have made it possible to cure the chronic disease that many had thought they would have for life. The new treatment is available to any adult Australian with a Medicare Card.
One in five of people with chronic hepatitis C don’t know they have the infection, or that a simple course of tablets could rid them of the virus damaging their liver. There may even be some people who think they can wait because they have not experienced any symptoms. Unfortunately, liver damage can occur without symptoms; at Hepatitis SA we are sadly aware of many who have been cured of hepatitis C but who are still dealing with poor liver health due to earlier damage.
Hepatitis C. Don’t Wait. Get tested. Get cured.
Australia is one of the countries on track to eliminate hepatitis by 2030 – a World Health Organization target but the number of people starting hepatitis C treatment has been falling after the initial surge when the new drugs became publicly available in 2016. The 2020 drop in diagnosis, and resulting management, will have flow-on effects on progress towards achieving the WHO target.
Hepatitis B and hepatitis C are infectious diseases with possible serious consequences for those with these chronic conditions, but they are treatable and preventable. With an effective vaccine for hepatitis B and a cure for hepatitis C, both viruses can be eliminated. The challenge is to find those who are not diagnosed, or not in medical care and offer appropriate pathways for them to cure or manage their condition.
Hepatitis – Don’t wait.
Learn more. Take the Stop B Cure C quiz and win a holiday!
Visit hepsa.asn.au/stopbcurec or use the QR code below.
For more information on World Hepatitis Day 2021, visit worldhepatitisday.org.au for the national campaign and worldhepatitisday.org for global campaign information.
]]>If you haven’t achieved some great new thing while in isolation, there is something wrong with you. At least that’s what some social media influencers would have us believe.
Motivational posts urging you to learn a new language, start a new business or acquire new knowledge, label you as lacking in discipline if you achieved none of those grand goals.
Truth is, if you are anything like me, you’d have been struggling to bother to even get dressed each day.
Isolation at home has not been free time in any normal sense. There is a deadly global pandemic and it is ok not to be ok with this. People are dealing with job losses, reduced incomes and fears about the illness for self or loved ones.
Even if we are among the lucky ones to retain our jobs, we may find difficulty focusing, with additional demands at home such as a houseful of children to keep occupied. These are strange and uncertain times.
It is also time for self–compassion.
Kindness to oneself is not practised enough, in my opinion. We are our own worst critic; cruel and unforgiving to ourselves. We often fail to understand that we need to put ourselves first, particularly during this time of uncertainty, so that we are there for others who need us. The oft-cited example to support the rationale of self-care is oxygen masks on airplanes.
The flight attendant instructs you to “put your oxygen mask on first,” before helping others. Why is this an important rule for ensuring survival? Because if you run out of oxygen yourself, you can’t help anyone else with their oxygen mask.
…there seem to be very few things within our control… unless you are living with chronic hepatitis C.
We are in a challenging situation right now.
For most of us, all sense of normality has been turned upside-down and there seem to be very few things within our control… unless you are living with chronic hepatitis C.
Really? Yes, really.
Getting cured of hepatitis C is one of the easy things you can do to improve your health and make your life less stressful. It is one thing you can control during this time. With hepatitis C your health is compromised, and you may find that symptoms of COVID-19 are worse if you contract this virus as well.*
While this novel coronavirus is still proving a challenge to for medical researchers, they have got that other virus – the hepatitis C virus – in hand. New treatments are available that cure hepatitis C, quickly and with few side effects and over 95% success rate.
Curing your hep C will reduce your risks associated with COVID-19, reduce fatigue and help you be the best version of yourself for others, or even just for you. For most people, this cure can be achieved with pills taken over eight or 12 weeks.
In South Australia, we are so lucky; with very little effort you can contact your local viral hepatitis nurse and with their support, rid yourself of your hep C.
So, be kind to yourself. Just pick up that phone and give one of those friendly viral hepatitis nurses a call. With so much done by telephone these days, you might only need one face to face, and there’s a chance you may only need to get dressed once…
*https://hepatitissa.asn.au/blog/coronavirus-and-hepatitis/
You can be cured safely during COVID-19 restrictions
It is just pills, for 8 or 12 weeks
Talk to someone who has been cured – Call Hepatitis SA on 1800 437 222
Or call your local community viral hepatitis nurse
to arrange testing and treatment
North: Lucy- 0401 717 971 | Michelle- 0413 285 476
Central/West: Margery- 0423 782 415 | Deb- 0401 717 953
South: Rosalie- 0466 777 876 | Jeff- 0466 777 873
When I was cured of hepatitis C in 2016 with the new direct acting anti-viral pills, I was surprised at the enormous relief I felt when I was given the result: “hep C not detected”. A weight remarkably lifted off my shoulders immediately. Having lived with hepatitis C for more than 27 years, I had not realised the weight I had been carrying around—the of feeling being infectious.
I noticed this further when I had my first nose bleed after being cured. I’ve had nose bleeds from time to time but this one felt strangely freeing. I enjoyed being able to bleed and not worry about where the blood had dripped—bagging up my tissues, scrubbing my hands and the surfaces, to ensure no-one else would get my blood into their blood-stream somehow. Of course I still did all those things but not with the sense of urgency or worry.
I have really enjoyed that sense of freedom since being cured.
I can’t help feeling like I have swapped out one virus for another
Now with SARS-CoV-2 and the impact of COVID-19 on our most vulnerable community members, it is all reminiscent of when I had hep C.
I can’t help feeling like I have swapped out one virus for another. I don’t have COVID-19 (yet!) but I can’t help feeling those same infectious feelings and worry. Knowing that COVID-19 can transmits from one person to another while people feel well, really worries me.
Again, I am walking around feeling infectious. I am more aware of it with COVID-19 because we should all be aware of it. Practising social distancing, constantly washing my hands for the recommended 30 seconds, maniacally singing happy birthday (in my head) twice to ensure that all traces have been washed away, desperately trying not to touch my face, staying 1.5 metres away from everyone, not shaking hands, opening doors with my elbow. Observing surface protocol: wiping door handles and regularly used surfaces with 70% alcohol.
When I had hep C, even though it didn’t feel that way, the reality was that it was the responsibility of all to use universal precautions to prevent hep C transmission. With COVID-19 it is different. People should be responsible for themselves in that way but it goes further, it is about protecting others. It is about ensuring others don’t get it.
I read somewhere that epidemiologist had projected that between 20 and 80 per cent of Australians may get COVID-19, that 80 per cent of them will experience mild symptoms of COVID-19, 20 per cent will need hospitalisation and five per cent will end up in intensive care.
…I feel the weight heavily on my shoulders, to ensure people that I have contact with are not infected with COVID-19 as a result of that contact with me.
At the time of writing, the death rates for this virus had ranged from 0.7 per cent to 3.8 per cent*, depending on whether our health services can cope with the number of people needing care. Even at an optimistic one per cent mortality, the number of people in this country who might die from COVID-19 could be between 50,000 to 180,000.
With prevention being our best protection until an effective vaccination is approved (when? 6-9-12 months from now?), I feel the weight heavily on my shoulders, to ensure people that I have contact with are not infected with COVID-19 as a result of that contact with me.
There are many people in my life who are pre-disposed to complications and higher risk of death if they were to get COVID-19. One of the most important people in my life is aged 76, has hypertension, diabetes and a vitamin D deficiency, and is on non-steroidal anti-inflammatory medication. Five things that make it more likely that she will be at a higher risk of death from COVID-19. I don’t want her to get it and I don’t want her to be one of the people who ends up in critical care if the number of people in South Australia requiring health care exceeds the capability of our health care system.
I feel weighed down with trying to do all I can to drive down the rate of new infections but that’s ok, thankfully I had room on my shoulders because the weight of hep C had gone.
If you are feeling anxious about COVID-19 call:
For online chat, information and resources visit:
Source
*https://www.worldometers.info/coronavirus/coronavirus-death-rate/
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