There are so many amazing people working to improve the lives of people living with viral hepatitis, including many of the authors of articles in this issue.

By Andrew Reynolds july 9, 2021@AndrewKnowsHepC

​We reached out to advocates and leaders in hepatitis B and C, and asked them for their views on what’s needed to achieve viral hepatitis elimination. Here’s a selection of their answers


TO READ IN ITS ENTIRETY:
https://www.positivelyaware.com/articles/what-do-you-think-needed-us-achieve-viral-hepatitis-elimination

“To have the Office of National Drug Control Policy talking about ‘harm reduction’ is important,” said one public health expert. “I remember when you couldn’t say those words there.”

Dan Vergano BuzzFeed News ReporterLast updated on August 2, 2021, at 11:25 a.m. ET
Posted on August 2, 2021, at 6:00 a.m. ET

The Biden administration is pushing to reform state drug laws in its latest move aimed at preventing deaths among people who use illegal drugs. The new approach focuses on so-called “harm reduction” measures that promote safe drug use over abstinence and the threat of imprisonment.
On Monday, the Office of National Drug Control Policy announced a $2.5 million grant to draft model laws to support such harm reduction programs, increase drug treatment options, and reform criminal statutes that have harmed people of color in particular. It’s the federal drug policy office’s latest shift away from the “War on Drugs” strategy that was started during the Nixon administration 50 years ago.

It’s frankly refreshing to see this office talking about helping people, and not about punishing them,” said epidemiologist Traci Green, director of the Opioid Policy Research Collaborative at Brandeis University. “For better or worse, model laws for controlled substances have led to changes in the past. So it is smart, I think, to follow this path to reform laws that unfortunately need modernizing in many states.”
Last year, more than 93,000 people died of drug overdoses in the US, the highest number ever. The increase was driven in part by the social isolation created by the pandemic, as well as by the wider spread of fentanyl, a drug some 25 to 40 times more potent than heroin, into the illicit drug market. The awareness that overdose deaths are only increasing, combined with reports of HIV outbreaks among people who use drugs in West Virginia and Boston, has intensified efforts to move to a harm reduction approach in the federal response to drug use. In direct contrast, however, some cities, such as Charleston, West Virginia, and Atlantic City, New Jersey, have recently shut down needle exchange sites, which are known to decrease the risks of infectious diseases spreading among people who use illicit drugs.

​TO CONTINUE: https://www.buzzfeednews.com/article/danvergano/harm-reduction-biden-drug-laws?fbclid=IwAR2hEooKFJTxqtfknX-LrSqmr4w6XUQQmZ1_ftMWQfInSQKOBsfg

Although COVID-19 and other current events have shined a light on healthcare disparities, this issue is nothing new. Major recognition in the United States started about 20 years ago with Surgeon General reports documenting inequities in tobacco exposure and mental-health care among minorities. And yet, two decades later, many disparities have either persisted or worsened for people of color, LGBTQ populations, and other minority groups compared with White populations.
Health disparities are nothing new, but COVID helped bring them into sharper focus.
“[N]arrowing health disparities is key to improving our nation’s overall health and reducing unnecessary healthcare costs,” wrote the authors of a Kaiser Family Foundation (KFF) brief that discusses healthcare disparities, how COVID-19 has affected them, and current federal efforts to advance health equity.    
The issue is also a top concern for the AMA, which wrote “Recent studies have shown that despite the improvements in the overall health of the country, racial and ethnic minorities experience a lower quality of health care—they are less likely to receive routine medical care and face higher rates of morbidity and mortality than nonminorities.”
With systemic solutions lacking thus far, the AMA is encouraging doctors to examine their own practices to ensure equality in medical care.  
Let’s take a closer look at healthcare disparities and what can be done.

TO CONTINUE- :https://www.mdlinx.com/article/healthcare-equity-what-can-doctors-do/5Vbm8cXTEsfbtWdiLmNqkB?show_order=1&utm_campaign=ealert_073021_co

​CARL SCHMID , EXECUTIVE DIRECTOR, HIV+HEPATITIS POLICY INSTITUTE

This year, roughly 14,000 Americans will die from hepatitis C, an infectious disease that can be cured by a simple pill in a matter of weeks.
It's infuriating that our government hasn't done more to end this highly infectious disease that disproportionately impacts minorities and people struggling with substance use disorder. Curative drugs first hit the market in 2013. But hepatitis C cases actually rose 63 percent between 2015 and 2019, according to a new report from the Centers for Disease Control and Prevention.
In other words, an epidemic that could be wiped out is instead getting worse. As we mark World Hepatitis Day on July 28, we need the U.S government to step up and commit the resources and leadership to end hepatitis C, just like other governments are doing around the world.
Roughly 2.4 million Americans have been diagnosed with hepatitis C. The Department of Health and Human Services believes another million have contracted the virus but don't know it—and may thus be spreading it inadvertently. People with hepatitis C can go years without exhibiting symptoms, even as the virus attacks their livers. Eventually, the viral assault may lead to liver failure, cirrhosis, cancer and even death.


Not long ago, treatment was difficult. Doctors prescribed shots that caused severe side effects and cured only about half of cases.
Today, direct-acting antiviral pills are available that cure over 90 percent of cases in just eight to 12 weeks with minimal side effects. And, thanks to competition, treating hepatitis C has become cheaper. The cost of treatment fell from $899 per day in 2014 to just $201 per day in 2020, a 78 percent drop, according to the health consultancy Milliman.

TO CONTINUE READING-https://www.newsweek.com/we-can-end-hepatitis-c-why-arent-we-opinion-1613565?utm_term=Autofeed&utm_medium=Social&utm_source

By Josh Katz and Margot Sanger-KatzJuly 14, 2021 NEW YORK TIMES

As Covid raged, so did the country’s other epidemic. Drug overdose deaths rose nearly 30 percent in 2020 to a record 93,000, according to preliminary statistics released Wednesday by the Centers for Disease Control and Prevention. It’s the largest single-year increase recorded.
The deaths rose in every state but two, South Dakota and New Hampshire, with pronounced increases in the South and West.

Several grim records were set: the most drug overdose deaths in a year; the most deaths from opioid overdoses; the most overdose deaths from stimulants like methamphetamine; the most deaths from the deadly class of synthetic opioids known as fentanyls.
“It’s huge, it’s historic, it’s unheard of, unprecedented, and a real shame,” said Daniel Ciccarone, a professor of medicine at the University of California, San Francisco, who studies heroin markets. “It’s a complete shame.”
In recent years, annual drug overdose deaths had already eclipsed the peak yearly deaths from car crashes, gun violence or the AIDS epidemic.

The death toll from Covid-19 surpassed 375,000 last year, the largest American mortality event in a century, but drug deaths were experienced disproportionately among the young. In total, the 93,000 deaths cost Americans about 3.5 million years of life, according to a New York Times analysis. By comparison, coronavirus deaths in 2020 were responsible for about 5.5 million years of life.
The pandemic itself undoubtedly contributed to the surge in overdose deaths, with disruption to outreach and treatment facilities and increased social isolation. Overdose deaths reached a peak nationally in the spring of 2020, in the midst of the pandemic’s most severe period of shutdowns and economic contraction. But public health experts said there had been a pre-pandemic pattern of escalating deaths, as fentanyls became more entrenched in the nation’s drug supply, replacing heroin in many cities and finding their way into other drugs like meth.
After decades of increases, overdose deaths dipped slightly in 2018. But they resumed their upward course in 2019, and drug deaths were rising in the early months of 2020, even before Covid arrived.
Change in drug deaths from 2019Jan.+1,018Feb.+1,249March+1,363April+2,360May+3,597June+2,373July+2,371Aug.+2,078Sept.+1,621Oct.+1,229Nov.+1,122Dec.+1,304
Source: Centers for Disease Control and PreventionNote: Monthly drug deaths are based on provisional data and may not add up to the annual total.“We went into Covid with this issue,” said Regina LaBelle, the acting director of the Office of National Drug Control Policy. “Rates of overdose death were going up; they were on the upswing. Certainly, Covid didn’t help and likely exacerbated things, but we were seeing an increase before.”
On Tuesday, President Biden nominated a permanent director for the post, sometimes called the drug czar. The nominee, Dr. Rahul Gupta, a physician and the chief medical and health officer for the March of Dimes, was the former commissioner of public health in West Virginia, a state with one of the sharpest rates of increase in drug deaths last year.
José Benitez, the executive director of Prevention Point Philadelphia, said the continuing mixing of heroin and other drugs with fentanyls had driven up the overdose rate there. But he also noted the effects of the pandemic. His group, which provides services to people who use drugs, saw appointments drop by about 20 percent. Some of their funding was diverted to support Covid services.
He also said that Covid public health warnings about social distancing ran counter to the advice given to opioid users. If people are going to use drugs, they’re encouraged to use them around others, so someone can revive them if they overdose. “The messages were mixed at best,” he said.
Mr. Benitez said the last year had been hard on his staff. It was not uncommon for two clients to die every week. “I was a social worker during the AIDS era,” he said. “This is, in lots of ways, almost a repeat of that.”
The C.D.C. will provide final estimates in a few months (overdose death investigations depend on toxicology reports and other testing that take time). No region was spared from the increased death toll. In the Northeast and Midwest, where the opioid epidemic was most acute in earlier phases, deaths continued to rise. But the biggest increases were in the South and the West, regions that had been less afflicted.
Rising deaths in the West, in particular, suggest a possible new phase in the epidemic. The national rise in deaths in recent years has been attributed in part to the introduction of fentanyls, which are easier to manufacture and ship than traditional heroin. Fentanyls began regularly appearing in the East Coast’s heroin supply in the last seven years, where they were easy to mix with the most common type of heroin, also a white powder. Overdoses of fentanyls, with their high yet variable potency, tend to be more common than overdoses of traditional heroin.
In the West, where most heroin is sold as a stickier substance known as black tar, fentanyls had been less widespread. Researchers examining the drug supply there say they are seeing more fentanyls sold as counterfeit pills, or sold alone as an injectable drug. An increase in overdose deaths involving both meth and fentanyls suggests fentanyls have begun penetrating the stimulant supply, too.
“We’ve seen a westward expansion of fentanyl,” said Christopher Jones, the acting director for the National Center for Injury Prevention and Control. “That just increases the pool of people who are susceptible to overdoses.”
It appears that the pandemic may have briefly interrupted the flow of fentanyls from China into the United States. Chad Sabora, the executive director of the Missouri Network for Opiate Reform and Recovery, and a consultant to the government, said the drug supply in St. Louis was altered for more than a month. “Then, a huge influx,” he said. “People’s tolerance had gone down, and boom.”
White Americans were hit particularly hard in the early years of the opioid epidemic, but in recent years deaths have been growing fast in nonwhite populations. In 2020, overdose deaths grew faster in Black and Hispanic populations than in white ones.
The trend may reflect the growing reach of fentanyls, which are now often found mixed with stimulants like cocaine and meth. They are reaching groups that were less likely to become addicted to prescription painkillers earlier in the epidemic. The stresses of the Covid pandemic have also affected Black, Latino and Native Americans disproportionately, with the potential to affect patterns of drug use.
“The pandemic has been far more disruptive in communities of color than in white communities — the death rates, the infection rates, the unemployment rates, the food insecurity rates,” said Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health. “So many consequences of the pandemic have hit communities of color harder. So it’s not out of line for overdoses to do the same.”
Politicians, public health officials and clinicians have been battling the opioid epidemic for years. In 2018, Congress passed a package of bills meant to reduce the death toll by limiting overuse of prescription drugs and improving access to drug addiction treatment. And early this year, Congress allocated an additional $1.5 billion to fight the epidemic.
The pandemic brought some changes in addiction policy that may have saved lives. Temporary changes have made it easier for people enrolled in methadone treatment to take doses home with them, instead of requiring them to visit a clinic each day. Ms. LaBelle said more people in drug treatment had stayed enrolled as a result. Regulators also made it easier for people to seek medical care through telemedicine, another policy that may be extended beyond the Covid emergency. For the first time, federal funds (from the recent stimulus bill) can be used to buy needles and syringes for exchange programs, and to purchase rapid fentanyl test strips, which can be used to check whether drugs contain fentanyl.
These new initiatives, and the substantial new funding to fight the epidemic, could help, several scholars said. But Ms. LaBelle cautioned that the improvements may come slowly. “In a year, I hope some of the regulatory revisions have been extended,” she said. “I think it’s more five to 10 years when we’ll start seeing more of the fruit of our labors.”

TO CONTINUE READING:​https://www.nytimes.com/interactive/2021/07/14/upshot/drug-overdose-deaths.html

Jul 12, 2021,04:00pm EDT
John LaMattina
Contributor Health FORBES
I cover news on drugs and R&D in the pharma industry

When the breakthrough medications to cure hepatitis C were launched back in 2014 and 2015, the companies that launched the first drugs, Gilead and AbbVie weren’t praised for this major scientific advance. Rather, they were vilified for their high list prices. The headlines heralding the first of these drugs, Sovaldi, focused on the “$1,000 pill” which referenced the dosing regimen of one pill per day for 12 weeks costing $84,000. Forget the fact that hepatitis C can cause cirrhosis of the liver, liver failure leading to the need for a transplant, and liver cancer. Forget that previous treatments were minimally effective, caused people to have flu-like symptoms for the 12 month course of therapy and cost in excess of $100,000. Forget that many of these patients end up needing a liver transplant which costs in excess of $300,000. The focus was on price as evidenced by comments made at that time by the President of America’s Health Insurance Plans: “The company in this case is asking for a blank check which, if granted, will blow up employer benefit costs….and wreak havoc on the federal debt.”

Well, the federal debt wasn’t overwhelmed by the cost of curing hepatitis C. In fact, thanks to competition resulting from multiple drugs being launched, within a year, the prices for these drugs in the U.S. dropped to less than $50,000 – cheaper than what was being paid in the U.K. and Germany whose governments negotiate prices directly with manufacturers for drugs. As a result, outrage over the cost of hepatitis C curing drugs largely evaporated. More noteworthy was that the World Health Organization began developing guidelines to eradicate hepatitis C by 2030 thanks to the availability of these drugs.

TO CONTINUE READING: https://www.forbes.com/sites/johnlamattina/2021/07/12/another-covid-19-calamity--more-deaths-due-to-hepatitis-c-infections/?sh=1b97b275644a​

Katie Mulvaney The Providence Journal ET July 7th 2021

PROVIDENCE — Gov. Daniel McKee on Wednesday signed into law a proposal to help combat the opioid overdose crisis by creating safe injection sites for people to use illegal drugs under the oversight.
The legislation, which makes Rhode Island the first to enact a statewide measure, establishes a two-year pilot program to prevent drug overdoses through the establishment of so-called “harm reduction centers,” or safe injection sites. The centers are defined as resources that provide health screening, disease prevention and recovery assistance where people may safely consume pre-obtained controlled substances. 
More:  Drug bills signal sea change in RI's approach to opioid crisis
“That’s amazing. … I’m a little taken aback,” Sen. Joshua Miller said upon learning from The Journal that McKee had signed the measure into law. Miller, D-Providence, has championed the harm-reduction legislation for several years.
Advocates have hailed the proposal as a much-needed tool as the state experienced a record 384 accidental overdose deaths in 2020 and is on track to possibly another record-breaking year.
The goal is to provide clean needles to curtail the spread of infectious diseases; test drugs; and provide a bridge to medical and substance abuse treatment.
The law signed by McKee requires the approval of a center by the city or town council in which it is proposed.  The director of the Department of Health will draft regulations governing the centers by March 1 with the advice of an advisory committee.
The funding would all come from foundations and private donors as the legislation does not earmark any public or taxpayer dollars, according to advocate Annajane Yolken. Because Rhode Island is a leader in this topic, the state is well-positioned to receive private funding for a pilot program, she said.
Miller said the next focus will be working with the health officials, the advisory committee, and Attorney General Peter F. Neronha on the regulations. 
The federal stance on the centers remains unclear. Federal prosecutors successfully blocked a so-called safehouse from being opened in Philadelphia by arguing that it would violate the U.S. Controlled Substances Act’s prohibition on “crackhouses.” A federal appeals court panel agreed, despite the American Medical Association's brief in support.
President Biden’s administration released its one-year drug policy earlier this year that focuses on racial equity and expanding access to prevention, harm reduction, treatment, and recovery services while reducing the supply of illicit substances.
TO CONTINUE READING:  ​https://www.providencejournal.com/story/news/2021/07/07/gov-mckee-signs-legislation-allowing-safe-injection-sites-into-law/7891057002/?fbclid=IwAR2uwWY6vtHVjTituzq7KOSliRRSHPg-yuW_Et9YZBkS-ijO98pRX4YWo2M

Cary James CEO, World Hepatitis Alliance

International donors can’t wait to join the fight to eliminate hepatitis. Without their support, low- and middle-income countries face the burden of expensive treatment for liver cancer.

Viral hepatitis is one of the most neglected global health crises of our time. Globally, it is the leading cause of liver cancer, and it claims over a million lives every year. However, we do have a vaccine and effective treatments against hepatitis B and a cure for hepatitis C. These tools combined with prevention and testing strategies mean we have the opportunity to eliminate viral hepatitis as a global public health threat, which will save millions of lives.

For too long hepatitis elimination efforts have been under funded, not prioritized, and poorly resourced. The COVID-19 pandemic has set the world back even further from achieving the elimination of viral hepatitis by 2030, which was a target set by the World Health Organization in 2016.

A pressing need

With a person dying every 30 seconds from a hepatitis related illness, we can’t wait to act on viral hepatitis — even while we are in the current COVID-19 crisis. The 290 million people who are unaware that they are living with viral hepatitis can’t wait for testing. People living with hepatitis can’t wait for life-saving treatments. Expectant mothers can’t wait for hepatitis screening and treatment. New-born babies can’t wait for the hepatitis B birth-dose vaccination.  And people affected by hepatitis can’t wait to end the associated stigma and discrimination. 

TO CONTINUE READING:https://www.futureofpersonalhealth.com/infectious-diseases/why-viral-hepatitis-elimination-efforts-need-immediate-support/?fbclid=IwAR0KmLmcCpIQ


Author
Cary James, CEO, World Hepatitis Alliance, us.editorial@mediaplanet.com
June 15, 2021

Overdoses have surged during the pandemic. Now, for the first time, Congress has appropriated funds specifically for programs that distribute clean syringes and other supplies meant to protect users.

By Abby Goodnough June 27, 2021 NEW YORK TIMES

GREENSBORO, N.C. — The thin young man quietly took in the room as he waited for the free supplies meant to help him avoid dying: sterile water and cookers to dissolve illicit drugs; clean syringes; alcohol wipes to prevent infection; and naloxone, a medicine that can reverse overdoses. A sign on the wall — “We stand for loving drug users just the way they are” — felt like an embrace.
It was the first day the drop-in center in a residential neighborhood here had opened its doors since the coronavirus forced them shut in the spring of 2020. “I’m so glad you all are open again,” the man, whose first name is Jordan, told a volunteer who handed him a full paper bag while heavy metal music riffed over a speaker in the background. He asked for extra naloxone for friends in his rural county, an hour away, where he said it had been scarce throughout the pandemic.
Overdose deaths rose by nearly 30 percent over the 12-month period that ended in November, to more than 90,000, according to preliminary federal data released this month — suggesting 2020 blew past recent records for such deaths. The staggering increase during the pandemic has many contributing factors, including widespread job loss and eviction; diminished access to addiction treatment and medical care; and an illegal drug supply that became even more dangerous after the country essentially shut down.
But the forced isolation for people struggling with addiction and other mental health issues may be one of the biggest. Now, with the nation reopening, the Biden administration is throwing support behind the contentious approach that the center here takes, known as harm reduction. Instead of helping drug users achieve abstinence, the chief goal is to reduce their risk of dying or acquiring infectious diseases like H.I.V. by giving them sterile equipment, tools to check their drugs for fentanyl and other lethal substances, or even just a safe space to nap.

​https://www.nytimes.com/2021/06/27/health/overdose-harm-reduction-covid.html?campaign_id=2&emc=edit_th_20210628&instance_id=34042&nl=todaysheadlines&regi_id=35