Kelly Rose Pflug-Back

This past Tuesday, July 28th, over 200 organizations around the world commemorated World Hepatitis Day by hosting events and campaigns, doing public outreach, and raising awareness about the often misunderstood viruses. Over 400 million people (or 1 in 12 people worldwide) currently live with viral hepatitis, and 1.4 million people per year die from these illnesses.
The word “Hepatitis” means “inflammation of the liver.” Non-viral forms of Hepatitis can result from exposure to chemicals or other toxic substances, heavy alcohol consumption, consumption of chemical drugs (prescription, over the counter, or otherwise), or autoimmune conditions which target the liver. Viral forms of Hepatitis however, which is the focus of WHD, result from viral infection of the liver. Viral forms of Hepatitis include Hepatitis A, B, C, D, and E. Each of these infections differs in terms of symptoms and transmission risks. While Hepatitis A, D, and E viruses (HAV, HDV, and HEV) are self-limited diseases (meaning that they resolve eventually on their own, with or without treatment) Hepatitis B and C (HBV and HCV) can become chronic and on-going infections in many patients.
HBV and HCV are disproportionately common among populations who use intravenous drugs. Using intravenous drugs alone does not increase chances of contracting blood-borne infections, but unsafe drug use and sharing injection equipment does. While both HBV and HCV are treatable, intravenous drug users who contract both HIV and HCV face increased chances of mortality. In a 2000-2009 study of 32,703 people living with HIV in Europe and North America, coinfection with HCV was linked to a 2.65-fold likelihood of death and a 10.89-fold likelihood of liver-related death.
People living with HBV and HCV in low- and middle-income countries also suffer disproportionately compared to their counterparts in wealthier nations and are less likely to be able to access treatment. As has been the case with HIV/AIDS, mass-scale treatment and subsequent decreases in transmission could be achieved if drug companies removed their patents and allowed manufacturers worldwide to market generic versions of the medications. There is no vaccine for HCV, so treatment as well as prevention through education and harm reduction are currently the only viable avenues to tackling the illness. Solvadi, a new HCV drug which has been hailed as more effective than previous ones with a success rate of 86-90 per cent, costs $1000 US for a single pill, which amounts to $84, 000 for an entire three-month course of treatment. This means that the treatments is unaffordable to poor and middle-income people even in highly developed countries. Governments and insurers in the US and Europe only offer subsidies to people with the most advanced symptoms, leaving others to become steadily sicker as they wait for treatment. Gilead, the manufacturer of Solvadi, offers some subsidies to low- and middle-income countries, but the the drugs are still unaffordable for many national budgets and individual patients alike.
Toronto celebrated WHD by hosting an event at the Central Toronto Community Health Center, which consisted of a free barbeque, info tables, harm reduction supplies, on-the-spot testing services, and live music by local artist DJ Vrak. The event was a collaboration between the three Community Health Centers in Toronto, including CTCHC, South Riverdale, and Sherbourne.

Rob, a long-time harm reduction activist in Toronto, expressed how good it was to see how far the harm reduction movement has come in the past few decades, and how many more programs exist for HCV-positive people than did 20 years ago. Around 500 people showed up to the event. “Some people came for the food, and ended up leaving with harm reduction supplies or using the on-the-spot testing service,” Rob said. He added that there is still much progress to be made in terms of HCV justice, including making access to new medications as low-barrier as possible and not restricting prescriptions to only those with advanced symptoms.
“I really like the turnout, and it’s great to see people from so many different organizations here,” said Celeste, who is part of the HCV group at CTCHC. Some of the organizations present included COUNTERfit, CATIE, and Black CAP.
Another attendee, who asked not to be identified, said that she was disappointed that more people with lived experience of HCV hadn’t been involved in setting up the event. “It was something that was talked about, but never really followed through with,” she said, adding that while she was pleased with how many community members showed up, she felt that the event should have prioritized HCV-positive people at an organizational level.