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Within our
grasp ResouRces coRneR
W George Allan finds FEAD
to be a website worth saving
We can win the war against
hepatitis C but we need to
seize the opportunity, says
Dee Cunniffe
e have seen great strides in the development of treatment for
hepatitis C in recent years. Revolutionary new drugs for this life-
threatening disease, which can result in cirrhosis, liver failure or liver
cancer, can save people’s lives and make a real difference. But the
battle has not yet been won.
Despite the introduction in 2014 of new direct-acting antiviral drugs, which can
cure hepatitis C in more than nine out of ten cases, there remain huge barriers to
those attempting to access treatment. Through our new report, the London Joint
Working Group on Substance Use and Hepatitis C (LJWG) reveals that increasing the
number of people treated with these medicines offers the potential to halve disease
burden in ten to 20 years.
This is an exciting and important opportunity in our efforts to reduce the
number of people dying from the disease by 65 per cent before 2030. However,
significant action and progress is needed to enable access to these life-saving drugs
– especially for the vulnerable, socially excluded sections of the population who
inject drugs.
Furthermore, this isn’t just about increasing access to the treatments
themselves. With 40 per cent of people living with hepatitis C in London estimated
to be undiagnosed, access is only half the battle. To successfully eliminate the
disease, we need to ensure this ‘silent killer’, which often remains undetected for
many years without symptoms, is diagnosed effectively. This will require services to
shift their approach across the patient pathway, from improving testing regimes to
enabling better access to drugs.
Current service provision across the country, and particularly in London, is often
patchy, disjointed and unable to support the needs of vulnerable, socially excluded
populations such as people who inject drugs.
SO, WHAT CAN WE DO TO IMPROVE SERVICES?
Firstly, we need to ensure there is more ‘joined-up’ thinking across services in all
London boroughs. Improved coordination will enable patients to receive the testing
and treatment they need, where and when they access it. Joint commissioning
arrangements should also be developed between clinical commissioning groups
(CCGs) and public health to ensure robust and deliverable pathways are established.
Secondly, all boroughs should create and implement a strategy specifically
targeted at addressing liver disease and hepatitis C. An important area to be tackled
here is reaching people who inject drugs. This remains the major risk factor for
becoming infected.
Our third key call is for hepatitis C antibody testing to be offered in more places
across the capital. Testing sho uld be accessible at all drug treatment services and
other venues, such as needle and syringe exchange programmes, as well as in
pharmacies.
While significant challenges remain to successfully eliminating hepatitis C, our
findings offer hope that we can significantly reduce the number of lives lost to the
virus. Joining up services and improving access to these revolutionary life-saving
drugs can enable us to halve the disease burden in ten to 20 years, helping us on
our way to achieving our targets. This might seem ambitious, but with the right
structural changes, it’s firmly within our reach.
Dee Cunniffe is a policy lead on the London Joint Working Group on Substance
Use and Hepatitis C (LJWG)
www.drinkanddrugsnews.com
Valuable
viewing
The recent demise of Lifeline calls into question the continued existence
of the Film Exchange on Alcohol and Drugs (FEAD). This website
(www.fead.org.uk) was set up in 2008 by Lifeline as a platform for sharing the
experience and knowledge of central figures in the field. The site has never
received significant publicity, which is a shame as it contains a wealth of
material which can both educate and challenge.
The site contains two types of video. Firstly, there are clips of individual
‘talking heads’ presenting their
views on aspects of theory, policy or
service provision. These usually last
less than five minutes, ensuring that
presenters concentrate on the core
of their arguments. Secondly, the
site includes full presentations from
conferences run by organisations
such as UK SMART Recovery, the
New Directions in the Study of
Alcohol Group and Scotland’s
Futures Forum. The richness, depth
and variety of the ground covered is
impressive. Here you will find such
diverse inputs as Nick Heather on
the confusion between moderating
alcohol consumption and controlled
drinking, Joy Barlow on early work
with drug-using mothers and John
Davies on how ‘addiction’ is socially
constructed and the implications of this for treatment and policy.
The opinions expressed cannot fail to enlighten, inspire or provoke. The viewer
may be surprised. If you think you can guess what Neil McKeganey’s attitudes
towards supervised injecting facilities might be, or David Best’s views of risk
reduction approaches, then you may have to reconsider. The site was established
around the time when ‘recovery’ was emerging as a contentious issue and this
has ensured that the topic is given a good airing. While a neat definition
continues to elude us, the views of such luminaries as William White, Griffith
Edwards and Annette Dale-Perera help to shed light on a slippery concept.
Fifteen minutes on the site is guaranteed to encourage viewers to step back
from immediate pressures and immerse themselves in aspects of the bigger
picture. As teaching aids the short videos are invaluable. The material is also an
important historical record: for this reason alone, it is essential that the site
continues and it is hoped that another organisation will take it over and
maintain and develop it.
‘Fifteen minutes on
the site is guaranteed
to encourage viewers
to step back from
immediate pressures
and immerse
themselves in
aspects of the bigger
picture. As teaching
aids the short videos
are invaluable.’
George Allan is chair of Scottish Drugs Forum. He is the author of Working with
Substance Users: A Guide to Effective Interventions (2014; Palgrave).
October 2017 | drinkanddrugsnews | 9