Titre : | Elimination of HCV as a public health concern among people who inject drugs by 2030 - What will it take to get there? (2017) |
Auteurs : | J. GREBELY ; G. J. DORE ; S. MORIN ; J. K. ROCKSTROH ; M. B. KLEIN |
Type de document : | Article : Périodique |
Dans : | Journal of the International AIDS Society (Vol.20, n°22146, August 2017) |
Article en page(s) : | 8 p. |
Note générale : |
Comment:
Role of community-based research in advocating HCV prevention and care. Carrieri P. Roux P. J Int AIDS Soc. 2017;20(e25005), doi: 10.1002/jia2.25005. |
Langues: | Anglais |
Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
Mots-clés : |
Thésaurus géographique INTERNATIONALThésaurus mots-clés HEPATITE ; SANTE PUBLIQUE ; LUTTE ; USAGER ; INJECTION ; TRAITEMENT DE MAINTENANCE ; REDUCTION DES RISQUES ET DES DOMMAGES ; ECHANGE DE SERINGUES ; INFECTION ; RECOMMANDATION ; RECHERCHE |
Résumé : |
INTRODUCTION: Globally, there is a considerable burden of HCV and HIV infections among people who inject drugs (PWID) and transmission of both infections continues. Needle and syringe programme (NSP) and opioid substitution therapy (OST) coverage remains low, despite evidence demonstrating their prevention benefit. Direct-acting antiviral therapies (DAA) with HCV cure >95% among PWID provide an opportunity to reverse rising trends in HCV-related morbidity and mortality and reduce incidence. However, HCV testing, linkage to care, and treatment remain low due to health system, provider, societal, and patient barriers. Between 2015 and 2030, WHO targets include reducing new HCV infections by 80% and HCV deaths by 65%, and increasing HCV diagnoses from
DISCUSSION: Challenges to HCV elimination as a global health concern among PWID include poor global coverage of harm reduction services, restrictive drug policies and criminalization of drug use, poor access to health services, low HCV testing, linkage to care and treatment, restrictions for accessing DAA therapy, and the lack of national strategies and government investment to support WHO elimination goals. Key recommendations for action include reforming drug policies (decriminalization of drug use and/or possession, or providing alternatives to imprisonment for PWID; decriminalization of the use and provision of sterile needles-syringes; and legalization of OST for people who are opioid dependent), scaling up and improving funding for harm reduction services, making health services accessible for PWID, supporting community empowerment and community-based programmes, improving access to affordable diagnostics and medicines, and eliminating stigma, discrimination, and violence against PWID.
CONCLUSIONS: The ambitious targets for HCV elimination set by WHO are achievable in many countries, but will require researchers, healthcare providers, policy makers, affected communities, advocates, the pharmaceutical and diagnostics industries, and governments around the world to work together to make this happen. |
Domaine : | Drogues illicites / Illicit drugs |
Affiliation : | The Kirby Institute, UNSW Sydney, Sydney, Australia |
Lien : | https://doi.org/10.7448/IAS.20.1.22146 |
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