We live in a world built upon achievements. We have travelled to the moon, developed vaccines, created the internet and even cloned life itself. Today we have the opportunity to create our next greatest achievement: the elimination of viral hepatitis. The journey has already started.
Since viral hepatitis was discovered 50 years ago, highly effective vaccines, treatments and a cure have been developed. Hepatitis B has a vaccine and hepatitis C has a cure.
Yet, worldwide, 95% of those living with these conditions are unaware. Less than 1% access treatment, and 1.4 million people die each year.
Furthermore, we cannot let the understandable global and Australian focus on COVID-19 take resources and time away from the vital work of testing and treating people living with viral hepatitis.
We are at a turning point. In 2016, 194 Member States of the World Health Organization made a historic commitment to eliminate viral hepatitis by 2030. At the 69th World Health Assembly, all governments unanimously voted to adopt the first ever Global Viral Hepatitis Strategy, signalling the greatest global commitment in viral hepatitis to date.
The Strategy set a goal of eliminating hepatitis B and C by 2030 and includes a set of prevention and treatment targets projected to save over 7 million lives.
In the five years since this strategy was launched, we have already achieved so much as a community. There were 188,951 Australians living with hepatitis C in 2016, but in the five years that have followed more than 40% have been cured. The coverage rate for hepatitis B immunisation in 12-month-old babies now exceeds 95% in Australia.
But for this good work to continue, and for viral hepatitis to be eliminated by 2030, it needs to be a national health priority. The first step to this is the VH2021 Action Plan, supported by numerous organisations in the liver health sector, both community and research bodies.
You can learn more and add your voice to those working together to eliminate viral hepatitis in Australia at 2030accord.org.au.
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The current federal government has an unfortunate track record for making impressive funding announcements, and then, months later, making them again as though they were new. Sometimes this is repeated several times–the recent manufacturing funding announcements which garnered wide positive media coverage have now been announced multiple times, without the money yet being spent. Consider this summary from The Monthly‘s Nick Feik:
A plan for manufacturing is a great idea, for sure. It’s so great, in fact, that this is the fifth time in 15 months that he or Industry Minister Karen Andrews has announced one. In May and June this year, and on two occasions last year (May 2019 and Sept 2019), the Morrison government announced almost identical strategies. Last year’s announcement, for example, promised to create “1.25 million new jobs over the next five years” by co-funding investments in new technologies. You’d be right to wonder what happened to that strategy. And the others. The short answer is: very little.
Hepatitis Australia, the national peak body on viral hepatitis, is understandably concerned that the 2019 Health Budget funding for hepatitis commitments is yet to hit the ground, even as 2020’s announcements are made.
“Excellent science, acting with affected communities and solid implementation underpins good public health,” said Carrie Fowlie, Chief Executive Officer (CEO) of Hepatitis Australia. “Hepatitis Australia welcomed the Australian Government’s announcement of an additional $45.4 million over four years, commencing in 2019-20, to increase public health prevention and promotion activities to deliver on the goals of the five National Blood Borne Virus and Sexually Transmissible Infections Strategies.
“We are pleased that this funding from the 2019 Health Budget still stands, however we are concerned that the majority of this funding is yet to be allocated. This is particularly concerning given the falling hepatitis testing rates since the beginning of the COVID-19 pandemic,” said Ms Fowlie. “Pathology testing data shows that there has been a decline in tests for non-COVID conditions, and in the case of hepatitis we understand that the numbers have not yet recovered.
“Recent data from the Viral Hepatitis Mapping Project shows that Australia is no longer on track to meet the nationally agreed targets outlined in the National Hepatitis B and Hepatitis C Strategies 2018-2022.”
“We urge the Australian Government to release the implementation funding under the National Blood Borne Virus and Sexually Transmissible Infections Strategies. This funding is crucial to ensure that Australia meets its 2022 targets and Australia’s commitment to eliminating viral hepatitis is realised,” said Ms Fowlie.
Hepatitis SA is similarly concerned about the reduction in hepatitis testing and treatment (see our cover story here about why now is the best time to act), and we are extremely keen to see all government funding commitments met so that the lives of those living with hepatitis in Australia can be improved.
]]>The Australian Greens holistic policy on Drugs, Substance Abuse and Addition encompasses not just illicit drugs but also tobacco, alcohol and pharmaceuticals. The policy, in a nutshell, adopts a harm-minimisation approach that addresses addiction as a health issue with treatments covered by Medicare.
There are 14 principles on issues including harm minimisation, evidence-base approach, alcohol, tobacco, access to services, education and Aboriginal control of responses to the drug use issues in their communities.
The policy also lists 24 aims, the first of which is the reduction in rates “to close to zero”, of harmful consumption of drugs and other substances, including tobacco. Other aims include:
In its policy, the Greens also aims to establish an independent drug regulatory authority to develop, and continuously evaluate, evidence-based policies and programs.
Too many lives lost in pursuit of a universally flawed, scientifically unfounded approach…
CEO of AIVL, Dr Angella Duvnjak, applauded the Greens “courageous leadership” in launching this policy.
She said the party’s move to a policy focused on evidence-based harm-minimisation approaches that emphasise the saving of lives, should be welcomed by any compassionate and well-informed Australian.
“Too many lives have been lost unnecessarily in the pursuit of a universally flawed and scientifically unfounded approach… based on punitive and largely criminal justice responses,” she said.
“We know there are many in the community, across the political spectrum who support a well-informed and rational debate in this area. We encourage those people to show similar courage and lend their voices in support of a new conversation on this important issue.”
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Read the full Australian Greens drug policy
Read the AIVL release
No drug policy was found on the Liberal Party 2016 Election Policies webpage.
Australian Labor Party’s national drug strategy and tobacco policy,
The South African cricket captain’s controversial habit of polishing the ball with his saliva earned him a fine, and raised a storm of letters to The Advertiser. Among them was one titled “Dirty Saliva”, from Robert McRitchie, which proclaimed dramatically, and wrongly, that “SALIVA is a perfect medium for transmission of infectious viral diseases such as HIV and hepatitis C, just to name two.”
Regrettably, no attempt was made by the paper’s editors to set the facts straight: that, revolting though Du Plessis’ polishing technique might be, it could not be a source of HIV or hepatitis C as none of these diseases are transmitted via saliva.
Stepping up to the plate
Stepping in where the editors failed to tread, Hepatitis SA, SAMESH, SHineSA, and the Victorian Aids Council (VAC) have written a joint letter to the editor refuting Robert McRitchie’s claims.
…outdated, and based in the fear and hysteria of the days of the Grim Reaper campaign.
“His claim that viral diseases like HIV and hepatitis C are spread though saliva is completely wrong,” the letter said.”Never in the history of the HIV epidemic has there been a case of HIV being spread through spit or saliva. Likewise, there has never been a confirmed case of hepatitis C being spread solely through saliva.
“Claims like those made by Mr McRitchie are outdated, and based in the fear and hysteria of the days of the Grim Reaper campaign. They have no place in current discussions and ignore all scientific evidence.”
The letter also pointed to a resolution unanimously adopted on 18 November by delegates to the national HIV/AIDS Conference in Adelaide, condemning the governments of South Australia, Western Australia and Northern Territory over laws that force people accused of spitting on or biting law enforcement personnel to undergo mandatory HIV and blood-borne virus testing.
CEO of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Levinia Crooks, reflected the disappointment expressed by the conference delegates, pointing to Australia’s proud record of evidence-based HIV policy response.
“These laws are anti-scientific — the risk of transmission of HIV or other blood-borne viruses from saliva is practically zero. There is no justification for invading the privacy of people in custody by forcing them to undergo blood tests when there is no risk to the officer,” she said.
“We understand the considerable risks faced by police and emergency services when they go about their jobs, but this is not the solution. There has never been a case of HIV transmission from spitting or biting in Australia.”
The conference resolution was supported by SA Greens MLC Tammy Franks who described the laws linking spitting to the spread of blood borne viruses as “loopy”, “not based on science” and only serving to scare.
Note: The Australasian HIV & AIDS Conference is the premier medical/scientific conference in the Australasian HIV and related diseases sector. The 2016 Conference was held in Adelaide from 16–18 November, in conjunction with the Australasian Sexual Health Conference.
]]>The Silent Disease Report was a comprehensive study from the House of Representatives Standing Committee on Health, and can be read online here. It made 10 main recommendations about the way the Australian Government should respond to the ongoing epidemic.
(Interestingly, the main way in which the Silent Disease report itself fell short, in failing to recommend easy access to new direct-acting antiviral (DAA) medication for hepatitis C, has been overtaken by events. In 2016 a number of DAAs were made available on the PBS, and are performing extremely well: more than 90% of people who complete treatment are now free of their hepatitis C.)
In its long-awaited response, the Federal Government has fully agreed with only three of these ten recommendations (numbers 1, 6 and 7), though it claims that funding has been provided to support several more. Several recommendations are merely ‘noted’ in the governmental response.
Disappointingly, The Government has ruled out a national hepatitis C awareness campaign, saying “To change the wider community’s beliefs and attitudes around hepatitis C will only result from a long-term ongoing discussion within the community as a whole. Community leaders (including political and cultural leaders) will be pivotal in engaging with the wider community on these issues.” This may be true, but the Australian community has a vast number of issues to consider at any one time. Without an awareness campaign to provide information and prompt reflection, it is likely that serious discussion of hepatitis C will not be heard above the noise.
The Government has agreed, in principle, that standardised data collection in prisons is valuable, and it will engage with the Australian Institute of Health and Welfare for future versions of the ‘Health of Australia’s Prisoners’ report. However, the Government has not agreed to recommendations for a National Strategy for blood-borne viruses in Australian prisons. They have instead stated that any action on hepatitis C in prisons is the responsibility of the various State Governments.
The Australian Government’s statement is that “[We are] willing to work with states and territories on [hepatitis C in prisons] if they wish to raise it as part of the COAG Health Council process.” This characteristic unwillingness on the part of the Federal government to take the lead on an important issue means that all state hepatitis organisations, like Hepatitis SA, must keep up the pressure on their State governments to bring the matter up for discussion.
You can read the Australian Government’s responses to the report here.
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