The personal experiences of people affected by hepatitis C are very important in informing the Parliamentary Inquiry into Hepatitis C in Australia.
The following facts and figures are provided to inform the content of your submission to the Inquiry but not to influence your personal views. The information is grouped under the headings of the Terms of Reference for the Inquiry Committee and is based on data from the latest reports available. You are encouraged to utilise the headings to guide the structure of your submission and you may wish to discuss all of the areas or focus on the section most relevant to you.
More detailed information to inform your submission please go to: hepatitisaustralia.com/inquiry
If you have further questions about the Parliamentary Inquiry, or would like some support to complete your submission, you can contact your State and Territory based hepatitis organisation on 1300 437 222
Deadline for Submissions: 27 February 2015
Facts and figures.
a.) Prevalence of hepatitis C in Australia
Almost a quarter-of-a-million Australians (230,000 in 2013) are currently living with hepatitis C.
Thousands of Australians (5,400 in 2013) are still contracting hepatitis C each year.
- In 2013 alone, 630 people died due to their hepatitis C and these numbers will increase without immediate action to increase the number of people getting treatment.
- Hepatitis C is the leading reason for liver transplantation in Australia (32%), but many people who need a liver transplant currently miss out.
- Blood-to-blood contact through sharing injecting equipment is the most likely way of getting hepatitis C. However, the majority of people currently living with hepatitis C no longer, or have never, injected drugs.
- People living with hepatitis C are diverse, and it’s important to acknowledge that hepatitis C disproportionately impacts people from marginalised populations including people who inject drugs (PWID), Aboriginal and Torres Strait Islanders, people from CALD backgrounds and prisoners.
- Increasing the access to the latest treatments, yet to become available in Australia will save lives and will help reduce the number of people living with hepatitis C.
b.) Early testing & treatment options in primary care; acute care, Aboriginal Medical Services and prisons.
- Testing for hepatitis C requires a blood test. An initial antibody test indicates contact with the virus. A second test, called a PCR or RNA test is required to confirm if a person has the virus in their body.
- Many people are unaware they may have been exposed to hepatitis C and many people are diagnosed late due to a lack of obvious symptoms following infection.
- Rapid testing (e.g. finger-prick) has many benefits such preventing onward infections due to awareness of health status and quick referrals. It must be noted any positive rapid test result needs to be followed up for confirmation.
- Rapid testing is already available in other countries but no testing kits have been approved for use in Australia.
- The number of people receiving treatment for hepatitis C in Australia is exceptionally low by international standards.
- Only 2,800 of the 230,000 Australians (1.2%) with hepatitis C received treatment in 2013.
- In 2014, all Australian Health Ministers signed on to the National Hepatitis C Strategy 2014-2017, which includes a target of increasing treatment numbers by 50% each year.
- New, more effective and simpler treatments have been developed and available in other countries but Australians don’t yet have affordable access to them, as they have not yet been approved for subsidy by the Australian government.
- In most parts of Australia current treatment for hepatitis C is only accessible through specialist liver clinics in major hospitals, many of which have unacceptable waiting lists.
- Many people diagnosed decades ago who have not recently accessed care may be unaware of the latest developments in treatment or their current treatment options.
- The latest treatment options, which, in most cases, will not require the use of interferon or ribavirin, should enable treatment to be accessed through community-based clinics, including some GPs. This would also support greater access in regional and rural areas.
- All people with hepatitis C should have equal access to treatment and support, regardless of how they got hep C or where they want to access health services.
- Australian Governments have responded to other blood borne viruses more effectively with good results, so why haven’t they done so for hepatitis C?
c.) Costs associated with treating in the short term and long term impacts of Hepatitis C in the community.
- Yes, hepatitis C is a costly illness that currently places significant demands on the budgets of Australia’s Commonwealth and State/Territory governments. Initially these costs will increase.
- The costs associated with not increasing access to the latest treatments will also grow significantly due to the health impacts of long-term hepatitis C infection and the loss of life.
- Without a major increase in treatment access, the number of people diagnosed with primary liver cancer due to hepatitis C will increase by 245% by 2030
- New modelling reveals that without a significant change in the rates of treatment, Australia faces a 230% increased in liver related deaths due to hepatitis C.
- A report in 2012 stated, “For every dollar spent to treat the HCV infection, four more are spent to deal with the consequences of a failure to prevent, treat and cure it.”
- Greater investment in both prevention strategies and increasing treatment numbers is important to curb the longer-term impacts of hepatitis C on the health system.
d.) Methods to improve prevention of new hepatitis C infections, and methods to reduce the stigma associated with a positive diagnosis through.
- Needle and Syringe Programs remain the most effective strategy for the prevention of hepatitis transmission.
- Two government endorsed reports into the effectiveness of needle and syringe programs (NSPs) have found them to be highly cost effective with a return on investment of $27 for every $1 spent. Further to this the report stated that a greater investment would ultimately generate future savings.
- Despite clear evidence that there is high prevalence and high risk of transmission of hepatitis C in correctional settings, the introduction of NSPs in prisons continues to be blocked
- People affected by hepatitis C experience significant levels of stigma and discrimination.
- Stigma and discrimination against people with hepatitis C is caused by hep C’s close association with injecting drug use, itself an illegal and therefore highly stigmatised behaviour, and also because there is a lack of information and awareness in the community and among many health professionals about even the basic facts of hepatitis C
- The fact is many people did not become infected through injecting drug use. Prior to the introduction of screening in 1990, some people contracted hepatitis C through blood products. Today unsafe tattooing and body art are also considered as risks.
- The two most common settings for stigma and discrimination are healthcare and employment although it extends to most areas of a person’s life and can have serious detrimental impacts.
- Despite increasing public awareness having been a priority action in every National Strategy since 1999 and unlike other conditions, there has never been an Australian government-funded public awareness campaign
- Increasing community awareness and a focus on hepatitis C as a liver health issue is an important step in minimising stigma and discrimination.
- It is vital that the government work with the affected communities and other stakeholders to implement an appropriate mass media public awareness campaign.
For more information about the Inquiry you can visit the government website here