| The increasing burden of hepatitis C, particularly among people who inject drugs, requires comprehensive, well balanced and targeted policy and practice. The burden of hepatitis C remains underestimated by many policy makers, professionals and the public. There is, however, considerable evidence and expertise upon which guidance for effectively tackling hepatitis C in Europe can draw.
The key messages included in this report represent the most important aspects of interventions targeting injecting drug users. These have been identified through field work, the day to day experience of practitioners and a literature review. Starting with approaches to prevention, such as awareness and training, the messages go on to describe the most important elements of service delivery including monitoring, testing and improving access, all with an essential focus on the involvement of patients and service users. As all interventions work best embedded in a national action plan or strategy, this report closes with a brief examination of what makes these most effective.
Each individual message describes an action needed to improve the local or national response to hepatitis C, including the central guiding principles and key components of the approach. One or two examples, selected based on a set of common criteria, describe existing interventions for the particular topic. A reference section and suggestions for further reading complete the overview of each key message. Inevitably, many of the messages are related and depend upon the wider framework of interventions in place.
The selection of the messages included focused on information directly relevant to hepatitis C and (injecting) drug use. Most of these messages are also relevant for other communicable diseases, however, such as HIV and for public health in general. At the same time HIV- or public health-related recommendations and research findings are likely to provide useful insights which are or should also be applicable to hepatitis C.
Messages relevant to drug and health policy in general have not been included in this report. Specific attention is needed for vulnerable people including drug users because of the lack of accessible treatment and care, and the need to fight stigma, discrimination and marginalization. This need occurs everywhere, and forms a baseline from which all policies, strategies, services and interventions must advance if hepatitis C is to be effectively tackled in the world today.
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