The path to hepatitis C elimination: who are we leaving behind and why?

The 2016 World Health Organization (WHO) 2030 global elimination targets for hepatitis C virus (HCV) are: 80% of those with chronic HCV treated, 90% reduction in incidence and 65% reduction in liver-related mortality [ 1]. Unfortunately, in several states and countries without socialized healthcare systems, some insurance payers require abstinence from substance use to be eligible for access to HCV services, thereby creating additional access barriers for PWUD—despite the lack of data supporting this restriction. A meta-analysis reviewing primary care and community-centred HCV treatment indicated that these innovative models could improve uptake and completion of treatment, while maintaining comparable cure rates, regardless of ongoing drug use [ 10]. [...]qualitative interviews of methadone maintenance programme beneficiaries suggest that treatment with methadone or buprenorphine can reduce the frequency of injecting and HCV-related feelings of shame, and improve their self-care.