Canada has a history of being on the forefront of addressing hepatitis C, starting with Dr. Michael Houghton, an internationally recognized microbiologist at the University of Alberta, who was the first to co-discover hepatitis C and continues to work with his team to create a vaccine for the virus.
Hepatitis C incidence is highest amongst the most marginalized and vulnerable Canadians: people who use injection drugs, Indigenous peoples and people in prisons.
In addition to limited testing, the curious and maddening fact is that most Canadians with hepatitis C need to get more sick from the virus before they can access the treatments. Liver injury (called fibrosis) gets worse the longer a patient has hep C, and historically access to treatment was limited to those with particularly severe fibrosis because of the high cost of the medications. This situation is, thankfully, improving somewhat.
Last February, the pan-Canadian Pharmaceutical Alliance negotiated an agreement with several pharmaceutical companies to lower prices for six hepatitis C medications, which will make it easier for those with hep C to qualify for drug access. A number of provinces have announced changes in their provincial criteria and access is improving. In some provinces, however, access to medications is still somewhat restricted.
The story of hepatitis C also highlights broader social inequities and gaps in our health-care system. Hepatitis C incidence is highest amongst the most marginalized and vulnerable Canadians: people who use injection drugs, Indigenous peoples and people in prisons. Thirty-five per cent of the infections in Canada are among newcomers who come from high prevalence countries and have been exposed to hep C through the medical system. Yet these populations face the biggest barriers in accessing health-care services.
Canada could be poised to become a leader in its global response to hepatitis C. Last year, Canada endorsed the World Health Organization’s Global Health Sector Strategy on Viral Hepatitis, 2016-2021, committing us to the goals of eliminating viral hepatitis as a public health threat by 2030 and, specifically, to achieving a domestic diagnoses rate of 90 per cent, with 80 per cent of people living with hepatitis C being treated by 2030.
Hepatitis C could be — should be — a proud Canadian success story, building on the stellar work of Michael Houghton, our strong Canadian medical expertise, and the leadership coming from communities most impacted by hepatitis C. We need all Canadians to encourage our federal and provincial health departments to take action, ensuring medical access and health care for all.