Background:
People who use drugs face a high risk of hepatitis B and C. Despite affordable prevention and treatment options, most countries lag behind WHO’s 2030 elimination targets. Many harm reduction programmes fail to integrate hepatitis services, and specific outreach and activities for people who use drugs are frequently absent in hepatitis programmes. Harm Reduction International (HRI) created a hepatitis repository in 2022, updated it in 2024, and included new data in the Global State of Harm Reduction (GSHR) 2024 to improve understanding and response.
Methods:
We conducted an online expert survey with qualitative and quantitative questions from harm reduction stakeholders. Data collection for the ninth GSHR edition occurred from April to August 2024. We applied thematic analysis and expert peer review, supplemented by a literature review. The Hepatitis Repository provides global and national estimates, including for the nine Global State of Harm Reduction regions.
Results:
People who inject drugs sharing contaminated injecting equipment drives infections, contributing to an estimated 43.6% of new HCV infections globally.
Stigmatisation and criminalisation create barriers that prevent access to services, leaving people behind in elimination efforts. At least 7 countries require drug abstinence for HCV treatment, without evidence supporting this approach. Only 14 countries, mostly high-income, are on track to meet elimination goals.
The GSHR 2024, with 284 contributors from 101 countries, reports barriers to service access and regional prevalence rates of hepatitis B and C among people who inject drugs.
Access to hepatitis C diagnosis and treatment for people who use drugs is hindered by affordability, restrictive policies, stigma, and lack of harm reduction resources.
Conclusion:
Data on service availability and quality and hepatitis monitoring must improve. The Hepatitis Repository and GSHR 2024 highlight service gaps and the need for harm reduction to eliminate hepatitis B and C by 2030. |