NSW HEPATITIS INFOLINE
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hepatitis C

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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Can hepatitis C be cured?

Image by Arturo Castellanos | flic.kr/p/9SMdayCan hepatitis C be cured? The simple, and happy, answer is yes!

New drugs, known as Direct Acting Antivirals (or DAAs), are now available in Australia through the Pharmaceutical Benefits Scheme (PBS) and they offer a significant breakthrough in hepatitis C treatment. The previous form of treatment, a combination of interferon and ribavirin, is now history.

These all new hepatitis C DAAs – the brands of which sport tongue twisting names such as Epclusa, Harvoni, Marivet and Zepatir – are highly effective and have significant benefits and improvements compared to the old interferon/ribavirin treatment.

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Being cured of hepatitis C a “huge relief”

Jase BellOver 24,000 people in New South Wales have started treatment for, and been cured of, hepatitis C since 2016. While this is a great achievement for our community, it is estimated that a further 57,000 across the state are yet to seek treatment and cure. That number represents way more people than it would take to fill the Sydney Cricket Ground!

Thanks to groundbreaking medications, elimination of hepatitis C is now an achievable goal, but one which requires the combined efforts of government, the health sector, and community to be fully realised.

During Hepatitis Awareness Week (22–28 July) and with World Hepatitis Day on 28 July, Hepatitis NSW is encouraging all people across the state who are living with hepatitis C, to take advantage of new easy-to-take and highly effective medications.

The medications, which have a cure rate of 95 per cent, can be prescribed by any general practitioner, and cure is usually achieved within 8 or 12 weeks, with minimal or no side-effects. These new oral pill treatments have offered a revolutionary opportunity. It is important that people see their GP to be treated; while hepatitis C initially has almost no symptoms, if left untreated it can ultimately result in significant liver disease.

Jase Bell, a Hepatitis NSW community speaker, said he was unsure how long he had been living with hepatitis C before he was diagnosed 18 months ago. “I might have had it for up to ten years, and I was shocked to be diagnosed because I had no idea at all,” Jase said. “Fortunately, I was able to be treated and cured within a few short months. It was a huge relief, a great weight lifted off my shoulders.”

With so many people cured it is encouraging that progress has been made in reaching the NSW goal of eliminating hepatitis C across the state by 2028, but now is not the time to rest. It is essential that anyone who believes they may be living with hepatitis C, strongly consider commencing treatment, and get themselves cured. It’s equally important for all GPs across NSW to also join the effort if they haven’t already done so.

“I would absolutely recommend the cures to anyone living with hep C,” said Jase. “Just do it. You have nothing to lose and everything to gain.”

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