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NSW HEPATITIS INFOLINE

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawed

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawed

Media Release: NSW’s Mandatory Disease Testing Bill ill-conceived and flawedSpeaking at a NSW Legislative Committee Inquiry into the Mandatory Disease Testing Bill 2020, on Thursday 11 February, Hepatitis NSW restated our concerns related to this ill-conceived and flawed legislation.

Hepatitis NSW CEO Steven Drew said, “Hepatitis NSW absolutely supports frontline health and emergency services workers. We collaborate with many of them every day through our work. They should not be subjected to unnecessary threats or risk as they go about their job and it is abhorrent that attacks do occur that create health related stress and concern.”

“Frontline workers must be informed and educated in advance, and reassured by experts that, based on science and evidence, the likelihood of the transmission of a blood-borne virus as the result of spitting or skin contact with blood is non-existent,” said Mr Drew. On this basis, the inclusion of saliva within the definition of ‘body fluids’ which can be used to seek a mandatory testing order in the Bill is redundant and raises questions as to the real purpose of this legislation.

“We are part of a concerted effort by the community, government, and health sectors to eliminate both hepatitis B and hepatitis C in New South Wales by 2028,” said Mr Drew. “Efforts to date have resulted in the hard won ongoing decline in prevalence of hepatitis B and hepatitis C. Both viruses now present a numerically small and ever diminishing health risk in NSW.”

“There is an effective cure for hepatitis C and a vaccination for hepatitis B. This means the fear and worry, which this legislation validates, is unwarranted and not justifiable. Instead, rather than entrench stigma and discrimination, we need scientific, evidence-based information and education to reduce stress and anxiety for frontline workers who are at risk of incidents of exposure. This reflects New South Wales world leading approach and response to public health issues.”

This Bill will make it harder to reach the very people we must still reach to make good on elimination.

Since 2000, a comprehensive hepatitis B vaccination program in NSW means an entire generation of young people are not at, and pose no risk of, infection. Additionally, frontline workers should already be vaccinated against hepatitis B to mitigate occupational health and safety risks of blood borne virus transmission.

Furthermore, an effective cure for hepatitis C is universally available through the PBS, including for young people aged 12 and above. That this Bill applies to young people aged 14 years and above is as unjustifiable as it is abhorrent.

“The importance of protecting and promoting the health, well-being, and mental health of staff, employees, workers and indeed the public is something we all agree on. Workplaces have an obligation to do everything possible to protect staff from injury and harm while carrying out their duties. Although the rationale for this Bill is to protect and promote the health and well-being of frontline workers we already, in fact, have the tools to do so.”

The current system already places the health and safety of the worker at the centre of risk assessment and prevention. It prioritises evidence-based assessment, treatment, and care. In the event of an incident, focus should always be placed on access to immediate assessment of risk by a qualified health practitioner, counselling, and support to the person. This support would see the commencement of any recommended aftercare, including post-exposure prophylaxis.

Mr Drew said, “Requiring an alleged assailant to undertake a blood test, potentially without consent and under duress, does not provide peace of mind. It would be an unnecessary and fallible substitute for the immediate clinical assessment of the affected worker by an expert and appropriate care protocols.”

It is important to state clearly and unambiguously that enacting this Bill will disproportionately and adversely impact an already disadvantaged population, notably street present and marginalised people – specifically Aboriginal and Torres Strait Islander people, as well as people who have substance dependence, gender identity, and mental health issues.

“The Bill will effectively offer no increased peace of mind to frontline workers,” said Mr Drew, “but would instead expose predominantly marginalised individuals to unnecessary and invasive blood testing, potentially inflaming violent behaviour and increasing the risk of injury to both the alleged assailant and the frontline worker.”

  • Download our submission>>> CLICK HERE
  • Read other submissions – NSW Parliament site>>> CLICK HERE

For more information, please contact:

Hepatitis NSW
Steven Drew, CEO
sdrew@hep.org.au
0402 518 285

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Hepatitis NSW Submission: Mandatory Disease Testing Bill 2020

Mandatory Disease Testing a futile and stigmatising exerciseHepatitis NSW has provided a submission on the Mandatory Disease Testing Bill 2020 currently being considered by the State Government, and will shortly be attending a committee hearing at NSW Parliament House. Hepatitis NSW has opposed mandatory disease testing since it was first considered following recommendations arising in the 2017 NSW Legislative Assembly Committee on Law and Safety Report. Our position remains unchanged.

Download our submission>>> CLICK HERE

The proposed bill won’t address risk to frontline workers

We strongly believe that the wellbeing and safety of frontline workers in NSW is vitally important. In terms of wellbeing and safety, we are referring not just to the physical but also to mental and emotional wellbeing. Our frontline workers deserve the community’s respect and should not be subject to acts of intimidation, threats or violence in any form. They must be protected as much as is reasonably possible in a high-level occupational risk environment.

In providing that protection, it is essential that the strategies designed and used are scientifically informed, evidence-based and effective in meeting the aim; that they are fit for purpose. Where the issue being addressed is a health issue, the response must be health based, not based on criminalising affected people.

A health informed and based response provides a holistic, wraparound approach that draws on appropriate health promotion, medical support, interventions and care to the primarily affected person. Force and criminalisation against a third party is punitive and does not provide sanctuary for a victim.

This Bill is a blunt instrument that is wholly incapable of achieving anything other than a perpetuation of fear, loathing, discrimination and privileging that is inconsistent with the inclusive, fair and responsible society and behaviour we would all desire. It will not address the stress and concerns of frontline workers around the exceedingly low risk of infection. Indeed, greater results will be achieved through supporting them with accurate information about risks, addressing their concerns, and providing professional wellbeing, support and counselling.

We do not support mandatory testing

Mandatory testing is not in line with the Australian National HIV, Hepatitis B or Hepatitis C Testing Policies, or supported by global health bodies. The key principles guiding blood borne virus (BBV) testing in Australia are that testing is conducted ethically, is voluntary and performed with the informed consent of the person being tested.

Mandatory testing does not meet these principles. Mandatory testing laws are not supported by global health bodies such as UNAIDS and the World Health Organization on the basis that it breaches human rights, compromises public health initiatives and other efforts to eliminate HIV and other BBV transmission.

  • Download our submission>>> CLICK HERE
  • Read other submissions – NSW Parliament site>>> CLICK HERE

For more information, please contact:

Hepatitis NSW
Steven Drew, CEO
sdrew@hep.org.au
0402 518 285

Read more

Mandatory Disease Testing a futile and stigmatising exercise

Hepatitis NSW firmly rejects the premise behind the proposed laws outlined in a joint media release – Mandatory Disease Testing for Those Who Attack Frontline Workers – issued yesterday by the offices of NSW Justice Ministers David Elliott, Anthony Roberts, and Mark Speakman.

The proposed bill won’t address risk to frontline workers

Mandatory Disease Testing a futile and stigmatising exercise

Hepatitis NSW CEO Steven Drew said, “Hepatitis NSW strongly supports the wellbeing and safety of emergency services personnel. We agree they must be protected as much as possible in a high-level occupational risk environment.”

Mr Drew said, “This proposed Bill will not responsibly address the fundamental issue of risk to frontline workers.”

There is no risk of hep C or hep B transmission through saliva

Any decision on mandatory testing should be based on medical and scientific evidence. The risk and likelihood of transmitting blood borne viruses (BBVs) – hepatitis C, hepatitis B, and HIV – through contact with saliva or spitting is effectively zero. Testing people who have not genuinely placed other people at risk is futile. The emergency worker may, in fact, miss out on health protections due to such a misinformed approach.”

Mr Drew said, “NSW has, until now, had a long and proud history of leadership in bipartisan, evidence-based, considered public policy responses that balance public health and individuals’ human rights. This proposed approach does a disservice to NSW as a national leader.”

Community organisations have not been consulted on the policy

Hepatitis NSW is extremely disappointed that this futile policy has been committed to by the government without consulting community organisations with history, knowledge, and experience in BBV responses. The policy will stigmatise communities and people affected by blood borne viruses, and potentially any frontline worker subject to the flawed response. There are no gains to be made for public health nor Work Health and Safety.”

Emergency workers are best protected by well-informed risk management

“This is irresponsible and is not conducive to the development of evidence-based, reasoned policy responses,” said Mr Drew. Frontline workers’ work health and safety are best protected by a well-informed risk management approach; this includes vaccination for hepatitis B and, where any blood to blood exposure risk occurs, a rapid assessment and response by medical staff.”

For more information, please contact:

Hepatitis NSW
Steven Drew, CEO
sdrew@hep.org.au
0402 518 285

Read more

Use of Fincol in NSW prisons: preventing hep C transmission

FincolWe know from the ample evidence before the NSW Special Commission of Inquiry into the Drug ‘Ice’ that, like it or not, drugs and injecting equipment find their way into, and are used in, prisons. This is an unavoidable reality.

Hepatitis NSW strongly supports the ongoing provision and use of Fincol as a disinfectant in correctional settings.

Regarding evidence provided to the current Inquiry – and the reporting of that evidence – the impression has been given that Fincol is of ‘dubious efficacy’ when used by people in prison as a disinfectant to clean syringes and other equipment used to inject drugs.

Using Fincol is better than using nothing at all

We know that when Fincol is used as per the manufacturers’ instructions, it is effective in killing hepatitis C and other blood borne viruses.

It is not the efficacy of Fincol that should be questioned, but rather the circumstances surrounding Fincol’s availability and usage, as it is these factors which lead to injecting equipment not being adequately disinfected.

Fincol is not readily available in all areas in NSW prisons. Furthermore, when it is used, people in jail often do not have the ability or time to clean scarce injecting equipment as per the instructions.

Fincol poster

Excerpted from a poster produced by Hepatitis NSW for distribution in NSW Prisons to promote correct usage of Fincol.

Despite these shortcomings, it is far better for people in prison to use Fincol to try to disinfect injecting equipment as thoroughly as possible, rather than not clean the syringes at all.

A preferable solution: Prison Needle Exchange

What would be far more effective is the provision of sterile injecting equipment, on a strict one-for-one exchange basis, to people in prison who inject drugs.

To reduce the risk of transmission of hep C and other blood borne viruses in prison, a controlled needle exchange system is essential. Needle exchanges exist in prisons overseas, including in Canada.

We note that drugs are illegal both in prison and in the broader community. Regardless, widespread needle and syringe programs (NSPs) are available in the broader community and serve as a highly effective means of preventing the transmission of hep C and other BBVs among people who inject drugs, however they are not available in any prison in Australia.

There is not, therefore, an equivalence of health care provision between people in prison and people in the broader community.

Prison officers are at greater risk from accidental needle stick injuries, and potential HCV infection, with the current system of uncontrolled needle use, where syringes carry a high value and are difficult to disinfect, than they would be under a tightly controlled needle exchange program.

In the meantime use Fincol to disinfect injection equipment

While this debate around Fincol and prison based needle exchanges continues, it essential that people in prison be provided with the means to disinfect injecting equipment as best they can. Fincol is currently the only available means.

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