ENDING THE EPIDEMICS: A FOCUS ON PEOPLE WHO INJECT DRUGS Chris Taylor, Senior Director, Hepatitis National Hepatitis Technical Assistance Meeting December 5-7, 2016

The Challenge Ending the Epidemic: Hepatitis C Our Premise: We will not eliminate hepatitis C in the U.S. unless we have a specific focus on the prevention, care, and intertwined needs of people who inject drugs This prioritization must include political will, increased funding, and a social justice approach

NASTAD Call to Action NASTAD is drafting a document calling for action: Framing as a health equity and social justice issue Prioritize primary prevention among PWID Prioritize testing and vaccination among PWID Eliminate treatment access barriers and prioritize HCV treatment for PWID Address the intertwined epidemics of substance use, mental health, overdose prevention ,etc. Provides recommendations for a range of stakeholders

NASTAD Call to Action Call to Action on Addressing Hepatitis C Among PWID We are not doing enough as a nation to urgently respond to the hepatitis C epidemic We will not stop this epidemic unless we make prevention and treatment of hepatitis C among PWID the highest priority Reducing hepatitis C infections is a public health imperative and a matter of social justice A critical moment for reducing infections and saving lives The right people, in the right places, and this must occur right now

NASTAD Call to Action Recommendations to include: Prioritizing Prevention, Care and Treatment for People Who Inject Drugs Preventing New Infections Through Harm Reduction Improving Testing, Diagnosis and Linkage to Care Prioritizing Prevention, Care and Treatment for People Who Inject Drugs Focus public health strategies for HCV on primary prevention for PWID Emphasize marginalized populations, including people of color, Native Americans, people who are homeless, incarcerated populations, individuals co-infected with HIV and hepatitis Conduct vulnerability assessments of populations who are not accessing prevention, testing and treatment services in rural, suburban and urban areas Preventing New Infections Through Harm Reduction Work with state and local policymakers as well as other community organizations to promote policies that aim to improve drug users’ health Fund access to needle exchange, clean drug injection equipment, syringe services Provide universal access to harm reduction by removing restrictions on funding, breaking down barriers in laws/policies/regulations Provide treatment and support services for people with substance use disorders Coordinate and integrate with behavioral health, substance use, injury control, and corrections to meet the needs of people who use drugs Partner with law enforcement and emergency services personnel on the provision of overdose prevention Engage drug user communities meaningfully in program development and activities Improving Testing, Diagnosis and Linkage to Care Improving and Supporting Surveillance for HCV Accessing Treatments Leading to Cure Breaking Restrictions on HCV Treatment Provider Education, Capacity and Expertise Strong Public and Private Insurance Protections Expanded Medicaid Coverage for People Living with HCV Coordinating Federal, State and Local Responses

NASTAD Call to Action Roll Out Release to capitalize on the National Academies Hepatitis Elimination Strategy Blog Posts Incorporated into Presidential transition strategy Incorporated into Congressional education and appropriations strategy Will guide TA efforts to health departments in 2017