Every year, on 28 July, the World Health Organization (WHO) and partners commemorate World Hepatitis Day to increase awareness and understanding of viral hepatitis and the diseases it causes. The focus of World Hepatitis Day this year is ‘Hep can't wait!', stressing the need to accelerate the fight against viral hepatitis and the importance of testing and treatment for the people who need it (1). To mark the occasion, the EMCDDA is showcasing its online toolkit designed to help European countries beat viral hepatitis. The practical resources aim to support countries in promoting HCV testing and care for people who inject drugs (PWID) through drug services.

Hepatitis C virus (HCV) infection is the most common infectious disease among PWID, being easily transmitted through the sharing of needles and syringes. While HCV antibody prevalence in the EU general population is below 2%, studies conducted among PWID show it can exceed 50%, making this a key target group for programmes to eliminate the virus. Despite the availability of new highly effective treatments for hepatitis C infection, access to testing and care for PWID still remains limited today. Eliminating hepatitis as a public health threat by 2030 is a target set by the UN Sustainable Development Goal on Health (SDG 3.3)(2).

The EMCDDA toolkit includes:

  • an interactive elimination barometer designed to support countries affiliated to the EMCDDA in monitoring their progress towards SDG 3.3;
  • a manual to help improve access to hepatitis C testing and care for PWID by prioritising testing in harm reduction and drug treatment settings;
  • examples of innovative models of care in some countries that have increased access to HCV testing and treatment through drug services.

The toolkit is part of a wider EMCDDA harm reduction initiative supporting countries in their efforts to prevent and control infectious diseases among PWID.

Through the barometer, for example, public health workers, policymakers and other interested users can access data to gauge their country’s performance according to 10 epidemiological indicators. Readers can download data tables and infographics and view which countries have achieved the targets set. Monitoring data suggest that most European countries are lagging behind in meeting goals.

As shown in the European Drug Report 2022, only Czechia, Spain, Luxembourg and Norway reported meeting the WHO 2020 targets of providing 200 syringes per year per person who injects drugs and having 40% of the population of high-risk opioid users in opioid agonist treatment (OAT), a protective factor against drug overdose. This suggests the need to scale up treatment and harm reduction services in Europe for PWID.

Needle and syringe distribution and opioid agonist treatment coverage in relation to WHO 2020 targets, 2020 or latest available estimate

An additional challenge to European services at present may be posed by people displaced from Ukraine, where the prevalence of hepatitis C among PWID is estimated at 64%. A recent EMCDDA report highlights that efforts are needed to ensure that displaced PWID already in treatment for HBV and/or HCV can continue treatment. Voluntary testing and appropriate therapeutic follow-up should also be more generally available (3). In terms of prevention, vaccination against hepatitis A and B should also be offered to displaced people, as should free and non-discriminatory access to drug treatment and harm reduction services.

Coming up

  • The EMCDDA and the European Centre for Disease Prevention and Control (ECDC) will publish later this year updated guidance on the ‘Prevention and control of infectious diseases among people who inject drugs’.
  • The EMCDDA is also currently working with five prisons in Europe to document models of prevention and care towards the micro-elimination of HCV in prison settings.