Aboriginal and Torres Strait Islander Health #WorldHepatitisDay News Alerts : #LetsTalkHep editorial contributions from @NACCHOChair Donnella Mills, Dr Jason Agostino , Dr Mark Wenitong , Troy Combo : Plus link todays @HepAus event

“We are so proud of the work done by our members and affiliates in preventing the spread of COVID-19, but we cannot lose sight of the need to reduce our viral hepatitis rates.

We are concerned about the harm caused to our communities from the spread of Hepatitis B and C and I encourage our people to get vaccinated and continue ongoing treatments.

Keep in touch with your local Aboriginal Community Controlled Health Organisations.”

NACCHO Chair Donnella Mills

The National Aboriginal Community Controlled Health Organisation (NACCHO) is spreading the message to all Australians that while the rates of hepatitis in Australia are declining, the Aboriginal and Torres Strait Islander peoples are being left behind.

Read / Download full NACCHO World Hepatitis Day press releases HERE .

“Great work has been done in improving immunisation rates against Hepatitis B and on treatment for Hepatitis C, yet the prevalence of viral hepatitis and subsequent liver damage remains high amongst Aboriginal and Torres Strait Islander people.

What is particularly concerning are rates of viral hepatitis in remote and very remote communities are five times higher compared to metropolitan areas.

In the COVID-19 environment, we want to urge everyone to continue their regular health care. This involves getting childhood immunisations and for those on treatment for Hepatitis, don’t change or stop treatments unless advised to do so by your treating doctor.”

NACCHO Medical Adviser, Dr Jason Agostino

“At Apunipima we provide screenings for Hepatitis in our clinics and work closely with prison screening programs to help control the disease being transmitted within communities when prisoners are released.

Hepatitis in our Aboriginal and Torres Strait Islander communities is a preventable disease, but with both short-term and potentially chronic implications, Hepatitis has a significant impact on our mob’s health.

We need to work together to ensure we practice prevention in our communities, but also that we get tested, detect the disease early and have access to best practice treatment and management.”

The Aboriginal Community Controlled Health Organisation (ACCHO), Apunipima Cape York Health Council’s Public Health Medical Officer, Dr Mark Wenitong

” In recognition of the inequitable burden of hepatitis C amongst Aboriginal and Torres Strait Islander people, EC Australia has developed an Aboriginal and Torres Strait Islander Peoples Strategy (The Strategy) that will inform and guide the activities of EC Australia.

The Strategy will cut across the four key components of EC Australia: health promotion, workforce development and health services delivery, implementation research and evaluation and surveillance.

This will ensure a holistic and comprehensive approach to accessible and culturally appropriate hepatitis C care for Aboriginal and Torres Strait Islander communities.”

Troy Combo EC Australia as the Program Manager for the Aboriginal and Torres Strait Islander Health Plan see Part 1 below

 ” Leading organisations unite to discuss COVID-19 impact on hepatitis C elimination in Australia on World Hepatitis Day

Australia’s leading drug and infectious disease organisations will join forces to call for a re-engagement in elimination of hepatitis C in an online event on World Hepatitis Day, Tuesday, 28 July 2020. “

See Part 2 Below for link todays event 

Part 1 EC Australia, Partnering to Eliminate Hepatitis C

Firstly, I would like to introduce myself, Troy Combo, I have a joint appointment with the Burnet Institute and am employed and based at University of Queensland, School of Public Health and have recently been appointed as the Aboriginal Program Manager for EC Australia.

I have worked in the Aboriginal Community Controlled Health sector since completing my Diploma in Aboriginal Health at Redfern AMS in 1994. I have held positions with local AMS’s, State Affiliates (AH&MRC & QAIHC) and I have also worked for NACCHO (2013-2014). More recently I was employed at Bulgarr Ngaru Medical Aboriginal Corporation (2015-2020).

Australia can be one of the first countries to achieve the World Health Organization’s target of eliminating hepatitis C as a public health threat by 2030.

In 2016 an estimated 188,951 Australians were living with the hepatitis C virus resulting in up to 630 deaths from liver cancer and liver failure each year. Aboriginal and Torres Strait Islander people experience a disproportionate burden of hepatitis C and account for 10% of all people living with the virus in Australia.

As a priority population in our own right, Aboriginal and Torres Strait Islander people are also overrepresented amongst people in custodial settings, people who currently inject drugs or previously injected drugs and people accessing drug treatment programs; all of which increases a person’s risk of contracting hepatitis C.

In 2017 notification rates for hepatitis C were 4.4 times higher than non-Indigenous Australians (168.1 per 100 000 vs 38.4 per 100 00) and the rates for newly acquired (evidence of acquisition in the prior 24 months) hepatitis C was 13.7 times that of non-Indigenous Australians (24.6 v 1.8 per 100 00 respectively).

In 2016, direct-acting antiviral (DAA) medication was made available on the Pharmaceutical Benefits Scheme (PBS) to most people living with hepatitis C, regardless of disease stage. DAAs have revolutionised hepatitis C care making elimination of hepatitis C possible; they are highly effective with efficacy rates over 95%, have minimal side effects, and require only 8-12 weeks of once-daily tablets. While initial uptake of DAAs was positive, by 2018 the number of people commencing treatment started to fall. If Australia is to achieve its elimination targets, it is crucial that testing remains high and that DAA treatments are provided to people with hepatitis C to cure people of hepatitis C and prevent further transmission.

Eliminate Hepatitis C Australia

Eliminate Hepatitis C Australia (EC Australia) is a nationwide, multidisciplinary project with the aim to achieve a coordinated response to eliminate hepatitis C as a public health threat by 2030. The project brings together researchers and implementation scientists, government, health services and community organisations, peak and other non-government organisations to increase hepatitis C testing and treatment in community clinics.

The specific goals of EC Australia are to:

  • Ensure that 15,000 Australians with chronic hepatitis C are treated and cured
  • Ensure that people identified with cirrhosis related to hepatitis C infection are treated and cured, and regularly reviewed to monitor for liver
  • Establish a national collaborative framework to facilitate a coordinated response to the elimination of hepatitis C as a public health threat from

In recognition of the inequitable burden of hepatitis C amongst Aboriginal and Torres Strait Islander people, EC Australia has developed an Aboriginal and Torres Strait Islander Peoples Strategy (The Strategy) that will inform and guide the activities of EC Australia. The Strategy will cut across the four key components of EC Australia: health promotion, workforce development and health services delivery, implementation research and evaluation and surveillance. This will ensure a holistic and comprehensive approach to accessible and culturally appropriate hepatitis C care for Aboriginal and Torres Strait Islander communities.

My experience working within the Aboriginal Community Controlled Health sector has shown how the model of care provided by these services is well suited to take up the challenge of the EC Australia goals. At EC Australia, we believe the “test and treat” model required to increase treatment uptake for Aboriginal and Torres Strait Islander people is an achievable goal at a local service delivery level.

We will be convening an Aboriginal and Torres Strait Islander Health Leadership Group in late 2020 that will provide expert advice and cultural governance for all EC activities as part of the Strategy. Our aim is to build strong networks and work closely with the viral hepatitis and the Aboriginal Community Control Health sectors. We seek to build on successful models of care and workforce development programs within these sectors, to expand and inform other areas.

Over the coming weeks we will be contacting organisations to participate in a mapping of current and/or past hepatitis C health promotion, workforce development and service delivery activities.

If your organisation would like to participate or learn more about the EC Australia Partnership and Aboriginal and Torres Islander Peoples Strategy you can contact Troy Combo at t.combo@uq.edu.au or by phone on (07) 3346 4617.

For more information please visit the below link:

https://www.burnet.edu.au/projects/410_eliminate_hepatitis_c_australia_partnership_ec_australia

 Part 2 Leading organisations unite to discuss COVID-19 impact on hepatitis C elimination in Australia on World Hepatitis Day

Australia’s leading drug and infectious disease organisations will join forces to call for a re-engagement in elimination of hepatitis C in an online event on World Hepatitis Day, Tuesday, 28 July 2020.

Australia is on track to become one of the first countries to eliminate hepatitis C, which is part of the global goal from the World Health Organisation (WHO) to eliminate hepatitis C as a public health threat by 2030.

However, the COVID-19 pandemic and related social isolation has impacted drug use, drug and hepatitis C treatment services, and the health of people who use drugs. This puts an increased risk on new hepatitis transmission, access to treatment, and the elimination goals for 2030.

The Australian Injecting and Illicit Drug Users League (AIVL), Hepatitis Australia, the Australasian Professional Society on Alcohol & other Drugs (APSAD), the Kirby Institute and National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney, have partnered to address what COVID-19 will mean for hepatitis C elimination in Australia.

CEO of Hepatitis Australia, Carrie Fowlie said, “Hepatitis C is a blood borne virus and people who inject drugs are a crucial priority population.”

“Not only is there a risk that the WHO 2030 elimination goal could be set back, but more immediate negative impacts could be experienced by people at risk of contracting hepatitis or seeking hepatitis treatment in Australia due to current and future social, health, and policy changes.”

CEO of AIVL, Melanie Walker said some of the new regulations and social requirements are impossible for people who use drugs to abide by.

“People who use drugs need to attend needle and syringe programs (NSPs) and be able to have ongoing access to the full range of harm reduction, pharmacotherapy and other drug and hepatitis treatments,” said Ms Walker.

“If people who use drugs cannot access these services, we could see an increase in sharing of injecting equipment, which could lead to increased cases of hepatitis C and compound the negative health outcomes already experienced by this group.”

In the newly released National Drug Strategy Household Survey 2019, illicit drug use was responsible for 75 percent of Australia’s acute hepatitis C burden of disease.

Professor Greg Dore, Head of Viral Hepatitis Clinical Research Program at the Kirby Institute, UNSW Sydney, said there had been encouraging recent data from the Australian Needle Syringe Program Survey on prevalence of active hepatitis C infection in people who inject drugs which had declined from 51 percent to 18 percent between 2015 and 2019.

“However, despite these declines in number of people with hepatitis C, continued declines in numbers being treated through 2019 and into 2020 compromises the achievement of WHO elimination goals,” said Professor Dore.

“More strategies are needed to raise awareness of the need for testing and availability of new hepatitis C treatments to eliminate hepatitis C by 2030.”

In a new NDARC study of 702 people who used drugs during COVID-19 restrictions and lockdown, it was found only 24 percent were able to avoid sharing drug injecting equipment.

Professor Michael Farrell, Director of NDARC, UNSW Sydney, said the research shows that people who use drugs want to limit their risk of contracting viral diseases like COVID-19 and hepatitis C, but this can be challenging due to a range of factors.

“We need to continue to find solutions that support people who use drugs to ensure hepatitis C elimination remains a priority.”

About the online event

Facilitated by health reporter Dr Norman Swan, this event brings together affected communities, doctors, scientists, health and community workers, researchers and the public to discuss the immense challenges COVID-19 brings to hepatitis C elimination and the health of people who use drugs, and to discuss strategies to ensure Australia stays on track to become one of the first countries in the world to eliminate hepatitis C.

Date: Tuesday, 28 July 2020

Time: 12:30pm – 2:30pm

Book here.

Speakers

  • Jude Byrne, National Project Coordinator, Australian Injecting and Illicit Drug Users League
  • Sione Crawford, Chief Executive Officer, Harm Reduction Victoria
  • Greg Dore, Head, Viral Hepatitis Clinical Research Program, Kirby Institute, UNSW Sydney
  • Carrie Fowlie, Chief Executive Officer, Hepatitis Australia
  • Jules Kim, Chief Executive Officer, Scarlet Alliance, Australian Sex Workers Association
  • Andrew Lloyd, Head, Viral Immunology Systems Program, Kirby Institute, UNSW Sydney
  • Stuart Manoj-Margison, Director, BBV, STI and Torres Strait Health Policy Section, Australian Government Department of Health
  • Amy Peacock, Senior Research Fellow, National Drug and Alcohol Research Centre, UNSW Sydney
  • Melanie Walker, CEO, Australian Injecting and Illicit Drug Users League
  • Michael Farrell, Director, The National Drug and Alcohol Research Centre (NDARC), UNSW Sydney

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