Ireland 'well behind' in reaching global target to eliminate hepatitis C by 2030

Sinn Féin health spokesperson David Cullinane was told Ireland is now ''challenged' in reaching a World Health Organisation target of elimination of hepatitis C by 2030. File picture: Gareth Chaney/ Collins 

Ireland is “well behind” in reaching a global target to eliminate
hepatitis C by 2030, with poor access to treatment outside Dublin highlighted as one reason for “missing thousands” of undiagnosed patients.

A report published on Wednesday and discussed at the Oireachtas health committee also found geographic disparities between access to care in prisons. A treatment programme announced for Cork Prison is not yet open because of staffing issues, the committee was told.

Recommendations in the report ‘Roadmap to Zero’ from the Hepatitis C Partnership focused on regional disparities and need to increase community treatment generally.

Secretary of the partnership Nicola Perry said: “From 2004 to 2019, 15,700 people in Ireland have been diagnosed with hep C. Each year around 600 to 700 people find out they have Hep C. There could be as many as 30,000 in Ireland living with the virus.” 

Some 5,000 people have been successfully treated with antiretroviral drugs but she warned of thousands who do not know they have this disease. It is known as the silent killer, as liver damage is often not noticeable in the early stages of the disease.

'Significant disparity' in access

However she highlighted a “significant disparity” in access, with five of the eight hospitals offering hepatitis C treatment located in Dublin.

She acknowledged a significant number of patients are in the eastern area, but called for more regional investment.

Referring to prisons, she said: “There is disparity in terms of the quality of care depending on where you are based."

“If you are in a Dublin-based prison at the moment, there is availability of treatment and an effective programme,” she told Fine Gael TD Colm Burke.

“If you are in Cork, although the National Hepatitis C Treatment Programme have endeavoured to implement a programme in Cork, it was announced last summer, that hasn’t actually worked because of staffing and resources.” 

She said across the South-East it is not known how many people might have the virus so effectively boosting supports is challenging.

Report author Marcus Keane said assigning officials to take this over in each HSE region or under the new regional health areas was crucial.

He said told Sinn Féin TD David Cullinane that following the pandemic Ireland is now “challenged” in reaching a World Health Organisation target of elimination by 2030.

'Well behind targets'

“We can see that we are well behind these targets,” he said. “The question is now the WHO has those targets there, we need a coherent strategy to be able to do that.”

Another barrier is that hepatitis C treatment is closely aligned to the opioid substitution programmes offering methadone. If this programme is not available, or if the patient is one of the 30% of hepatitis C patients who is not a drug user, this can cause challenges in access, the committee heard.

Dublin GP Austin O’ Carroll told Social Democrats TD Róisín Shortall: “We know there are big black areas down the country where you cannot access treatment“.

He said: “I’ve had some people, a number of people, who have come up from the country to become homeless so they could access opioid substitution treatment and hep C treatment.”

The committee also heard from partnership peer worker Larry Murphy, who previously had the virus. He said there is huge stigma and shame still attached to this, saying he felt “like an outcast”.