HaRdCOREhARMREdUCER: INPUD-Asia: Observing World Hepatitis Awareness Day in Asia

INPUD Chairman Anan Pun (Khatmandu, Nepal)

1 October 2007
Asian Network of People who Use Drugs
Asian Harm Reduction Network
Joint Communication

B etween 170 and 200 million people are currently living with hepatitis C (HCV) around the world, with HCV prevalence recorded at up to 93 percent among various injecting drug user (IDU) communities of Asia. Within the same population groups, HIV-HCV co-infection is becoming increasingly common. The sharing of injecting equipment among IDUs is a major vector for HIV and HCV transmission. It has been estimated that there are up to 9 million IDUs in the Asia-Pacific region. Out of the 7.4 million recorded people living with HIV in Thailand, Nepal, Indonesia, Myanmar and parts of India, Pakistan and China, more than half inject drugs [1] .

The international community remains ethically bound to act and must rapidly mobilise, for there is still an opportunity to bring about positive change. By investing, developing and implementing evidence-based measures responding to risk behaviours within drug user communities – including harm reduction measures like pharmacotherapy and needle and syringe exchange programmes – we can step closer to simultaneously neutralising two of the world's most devastating and rapidly expanding epidemics.

Today, we have a say and we demand that

■ Health agencies all over the world and particularly in Asia must acknowledge hepatitis – with a special attention to HCV;

■ Governments and policy makers should acknowledge the need and express a greater level of commitment to HCV diagnosis, prevention, treatment, care and support;

■ HCV among people using drugs must be appropriately covered in HIV/AIDS and drug strategies and programmes, as well as in the Universal Access framework, Global Fund programmes and other national, regional and international platforms;

■ People using drugs must be involved in the formulation, implementation, monitoring, and evaluation of all strategies and policies that affect their lives, including those strategies and policies addressing HCV prevention and treatment;

■ Repressive legislation and policies that criminalise drug use and people using drugs must be revised to effectively address public health issues, while reflecting a non-stigmatising approach;

■ Strategies to address HCV must be adopted with clear accountability mechanisms at international, regional and national levels;

■ Donors and foreign development agencies supporting harm reduction, HIV prevention and other services targeting people using drugs must include a HCV component in their programme;

■ All stakeholders must work more closely with communities affected by HCV and drug use to develop a comprehensive response to HCV, in order to increase access to diagnosis, treatment, care and support for people using drugs;

■ Hepatitis A and B vaccination should be made widely available, and considerations should be given to the production of local generic treatments for HCV;

■ Harm reduction programmes must not only be sustained, but urgently scaled-up and expanded to provide adequate coverage and a wide range of services including (but not limited to) needle and syringe exchange progreammes;

■ HIV testing should always be offered to clients with HCV, and HCV testing should likewise be offered to PLWHA;

For more information about HCV and the response in Asia, please contact Anan Pun (Asian Network of People who Use Drugs) and Pascal Tanguay (Asian Harm Reduction Network) at ananpun@gmail.com and pascal@ahrn.net respectively.

Ananda Pun
INPUD Chairman

Pascal Tanguay
Commuications Manager
Asian Harm Reduction Network