July 28th is World Hepatitis Day. Globally, 500 million people are living with chronic hepatitis B or C infections - yet don't expect this day to receive anywhere near the same level of attention and coverage as, for example, World AIDS Day or the various themed days for cancer. Awareness of hepatitis is inexplicably low, and the majority of people who have hepatitis are unaware that they are infected. Politically, hepatitis is simply overlooked or ignored - especially when it comes to people who inject drugs.
Of the world's 16 million people who inject drugs, nearly two-thirds are living with hepatitis C - just another example of an unacceptable, preventable harm exacerbated by the criminalisation and demonisation of drug users in the name of the "war on drugs".
Earlier this year, the Global Commission on Drug Policy - a high-level group of former Presidents and other world leaders - released a report entitled "The Negative Impact of the War on Drugs on Public Health: The Hidden Hepatitis C Epidemic". The Commission condemn drug prohibition as a failure, as punishing and stigmatising drug users only drives them away from prevention, testing and treatment services, and encourages practices and environments where risks are amplified. The mass incarceration of drug users is just one example of this.
The World Health Organization (WHO) has referred to hepatitis as a "viral time bomb" that poses a major public health, economic and social threat. The virus is highly infectious and easily transmitted through blood-to-blood contact - presenting disproportionate risks for people who inject drugs. A cure exists but is prohibitively expensive in most countries, with far less pressure placed on pharmaceutical companies to reduce prices for hepatitis C treatment compared to, say, HIV and cancer treatments. As a result, treatment access is appallingly low, especially for more marginalised groups.
We've long know that hepatitis infections among drug users can be prevented using proven harm reduction services that provide sterile needles and syringes as well as other interventions. Delivering these services at the scale needed to prevent hepatitis C will also be enough to prevent HIV (as the routes of transmission are identical for both viruses) - yet only a handful of countries can claim to do so. This will not change until drug policies change, until drug use is regarded as a health issue rather than a crime, and until hepatitis C is given the political and public attention that it deserves. If governments would divert just a fraction of the billions of dollars being criminally misspent on arresting and punishing people who use drugs, we could provide the testing, treatment and other support services to defuse this ticking time bomb.