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Opinion-A bold new approach to eliminating hepatitis C as a public-health threat

7/26/2019

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By John Wiesman and Carl Schmid
Special to The Times 

​
The consequences of the hepatitis C virus can be devastating if people are unable to access treatment. Left untreated, they can experience irreversible liver damage, cirrhosis, liver cancer and even death. Thankfully, investments in pharmaceutical research have led to new oral medications that allows individuals to be cured in as little as eight weeks, with few to no side effects. These medications have become more affordable as the price continues to drop due to competition.
Here in Washington, we know all too well the impact of hepatitis C. From 2010 to 2016, the number of reports of new infections (acute cases) rose by more than 280% statewide, with most occurring among young persons who inject drugs. Nationwide, cases of hepatitis rose by 350% during that same time period. These are upsetting statistics, but we know how to change this trend.
The World Health Organization and the National Academies of Science, Engineering, and Medicine have released reports showing that eliminating viral hepatitis as a public-health threat is possible both globally and nationally, and not only saves lives, but also saves money in the long run. However, elimination requires concerted efforts by states and communities, and an investment in resources. The U.S. has recently demonstrated this with the federal effort of “Ending the HIV Epidemic: A Plan for America,” which hopes to reduce new HIV infections by 90% in 10 years. We need a similar initiative to eliminate hepatitis C.
In some state Medicaid programs, access to the medications that cure hepatitis C has been restricted to only those individuals who have progressed to more advanced liver disease. Not only is this against Medicaid policy, it causes undue harm. Treatment restrictions are a significant barrier to eliminating the virus nationally.
Washington state has heeded the call to eliminate hepatitis and is taking action. Last year, Gov. Jay Inslee called on the state to eliminate hepatitis C by 2030, following the same goal the World Health Organization set in 2016. A plan titled “Hep C Free Washington” seeks to eliminate hepatitis C in Washington state by 2030 and will be released in the next few weeks. This July, the state also took an enormous step in these efforts when it finalized a new contract with drug manufacturer AbbVie to bring resources to the state to eliminate the virus. Under the agreement, the state has a guaranteed net unit price up to a certain treatment threshold after which it pays a nominal price for an unlimited supply of hepatitis C treatments. A similar agreement was recently reached between Louisiana and a subsidiary of the drug manufacturer Gilead.
TO CONTINUE READING: https://www.seattletimes.com/opinion/a-bold-new-approach-to-eliminating-hepatitis-c-as-a-public-health-threat/

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OPINION To fight opioid epidemic, treat drug use with compassion, not judgment

7/13/2019

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​Travis Rieder, Opinion contributor Published 7:00 a.m. ET July 9, 2019 | Updated 8:08 a.m. ET July 9, 2019

 I know from personal experience: We cannot expect people who use drugs to get better on their own or overnight.

It is vital that we meet them where they are.


​If news is what happens to editors, I suppose that scholarship is what happens to professors. At least, that was the case for me.As a researcher at the Johns Hopkins Berman Institute of Bioethics, I didn’t start thinking about America’s problems with pain and drugs through dispassionate research.
I got there thanks to a motorcycle accident, after which I was given lots of prescription opioids and then left to my own devices.

The result was that I formed a profound dependence on the drug, and then went through the agony of withdrawal as I tried — with no help from my doctors — to get off the meds.
​
That experience gave me a new perspective on the risks and benefits of prescription opioids, as well as a deep desire to help the millions of Americans who are suffering from addiction (and to prevent some of the tens of thousands of overdose deaths each year).

​TO CONTINUE READING: 
https://www.usatoday.com/story/opinion/2019/07/09/treat-opioid-users-with-compassion-not-judgment-colum

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Hep Community: We Need More Federal Dollars

7/2/2019

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A & U
Americas Aids Magazine
June 24, 2019

Money Talks
The hepatitis community wants more federal dollars; hep a cases rising fast
by Larry Buhl

Here’s the good news on federal funding for hepatitis research and treatment. In its 2020 budget proposal, the Trump Administration has requested a $53 million increase, from the current level of $5 million, to fund the infectious disease and opioids programs at the U.S. Centers for Disease Control and Prevention (CDC). The bad news is the budget for the response to all forms of hepatitis, including hepatitis A, B and C, is flat, at $39 million. That’s not nearly enough, according to Frank Hood, Senior Policy Associate at The AIDS Institute. He’s calling on Congress to allocate the additional $95 million requested by the hepatitis community for CDC’s viral hepatitis programs, and says that the CDC needs massive funding to expand its work in prevention, education, and testing for individuals at risk of hepatitis C, surveillance of outbreaks, and linkage to care for those who need it.
“President Trump has kept the same level of funding [for hepatitis] flat for three years,” Hood told A&U. “Any budget increases were due to Congress. And we hope that with a Democratic House, that budget item will be increased.”
Not only are cases of hepatitis C rising throughout the country, new populations are being impacted. In 2016, there were 41,700 new cases of hepatitis C, a twenty-two percent increase from the prior year. Between 2010 and 2016, there was a 350-percent increase in new infections. Unlike previous outbreaks that affected baby boomers, the biggest increase in infections today are among people under forty years old with more than seventy percent of cases the result of injection drug use.
“One reason we need increased funding is linkage to care, and this funding can be used for harm reduction,” Hood said.
On harm reduction there has been a shift in recent years, Hood added. “To our surprise, there is brief but well-worded support for syringe programs. There isn’t a fear of backlash around this and other harm reduction programs, but we want to make sure they get up and running, and again, we need resources for them.”
TO CONTINUE READING:   https://aumag.org/2019/06/24/hep-community-we-need-more-federal-dollars/
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