Nobody left behind - The importance of integrating people who inject drugs into HCV treatment programs

Hepatitis is a group of viral diseases that kills an estimated 1.4 million people around the world annually – a disease burden very similar that of HIV/AIDS and tuberculosis. Most of these deaths are caused by hepatitis B virus (HBV) and HCV.

HCV alone causes nearly half a million deaths each year, although HCV is curable in the majority of cases. Globally, an estimated 150 million people are chronically infected with HCV. The pandemic is concentrated in middle-income countries, where 73 percent of people with chronic HCV infection live.

People who use drugs – and specifically people who inject drugs – are disproportionately affected by the epidemic and bear by far the heaviest burden of HCV of any population. Moreover, hepatitis C is more than three times more prevalent than HIV among people who inject drugs.

The current predominance of repressive drug policies and the almost universal criminalization of drug use is the major structural driver of HCV and HIV transmission among people who inject drugs.

Only a fully public health–driven and human rights–based approach can make eradication a reality. This approach would need to include serious price reductions for all available treatment options, the removal of all structural barriers to access to HCV treatment for people who inject drugs in highly repressive legal environments as well as the scaling up of harm reduction efforts as the key tool of HCV prevention, drug policy reform, and the inclusion of people who inject drugs in treatment programs around the world.

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