The Champion Community: Issue 69

This issue:

1. A quick look at the Third National Hepatitis B Strategy 2018–2022
2. Closing the Gap at Yabun Festival 2019
3. Pet Pics get hep C messages to homeless and disadvantaged people
4. Men’s Sheds targeted for viral hep info
5. New FINCOL poster on cleaning fits in prisons

A quick look at the Third National Hepatitis B Strategy 2018–2022

As noted in December’s edition of The Champion, the Australian Government recently released the 5th National Hepatitis C Strategy and 3rd National Hepatitis B Strategy; both to run for 2018–2022. We discussed the Hep C Strategy in December (to read >>>CLICK HERE) and, as promised, have an overview of the Hep B Strategy in this edition.

Compared to the Hep C Strategy, the 3rd National Hepatitis B Strategy is somewhat less ambitious. Unfortunately, this may be a reflection on the lack of investment, expertise, and understanding of hepatitis B across the blood borne virus sector. There are however many important issues raised, all of which serve to set the groundwork essential for eliminating hepatitis B in the years to come.

Here are some key highlights and observations about the content of The Strategy:

• Meaningful involvement of priority populations: As with hep C strategy, the hep B strategy calls for a focus on the real and genuine involvement of people living with and affected by hepatitis B.
• Vaccination: While focus is almost always on newborn vaccination we must look to achieve high vaccination coverage across priority communities, not just in newborns.
• Evidence-based: The Strategy makes it clear that at the heart of the response to hepatitis B is a strong evidence base. We must keep this focus.
• Failure to meet targets: There was a failure to meet the most important targets of the previous Hep B Strategy.
• Increase diagnosis: The Strategy aims to increase the proportion of people diagnosed with chronic hep B to 80%. It is currently sitting at only 62%.
• Increased number of people with hep B in care: The target of The Strategy is to “Increase the total proportion of people living with chronic hepatitis B receiving care to 50%.”
• 20% receiving treatment: The Strategy has a target of 20% of people living with hep B on treatment.
• Reduce hep B-related mortality: The target of a 30% reduction is tied to increasing diagnosis rates and increasing in-care rates.
• GP prescribers: The expansion of the number of hep B treatment-prescribing GPs is an essential part of managing people’s hep B in their community and making regular care easier.
• Safer sex and sterile injecting equipment: Safer sex practices and the provision of sterile injecting equipment are also important in efforts to prevent hep B.
• Priority settings: As with the new Hep C Strategy, “priority settings” has been added here which is highly valuable in thinking about where people living with hep B might be easily reached.
• Aboriginal and Torres Strait Islander people: Too often hepatitis B is framed as a virus that centres on people born overseas. However, hep B disproportionately affects Aboriginal and Torres Strait Islander people. 11% of the people living with chronic hep B in Australia are Aboriginal and Torres Strait Islander. Also, liver cancer is the second highest cause of cancer-related deaths in Aboriginal and Torres Strait Islander people – over two times greater than the non-Indigenous population. Aboriginal and Torres Strait Islander people must be kept at the forefront of our responses to hep B.
• Mothers living with hep B and their children: It’s important to separate the issues for the child from the issues for the mother and consider them independently.
• Hep B diagnosis during pregnancy: There must be a greater focus in support and information for women who are diagnosed through antenatal screening.
• Hep B as a family health and cancer prevention issue: Reframing hepatitis B as a family health and cancer prevention issue makes for better engagement. This is a very welcome new focus.
• Testing in community: Hep B testing is still largely centred within medical services such as specialist clinics, medical centres and doctors’ practices. Instead, hep B testing should be more readily available in places accessed by priority populations.
• Link the hep B sector: The Strategy calls for connecting the clinical and community elements of hep B. Lessons can be learned from the excellent integration of all elements of the hep C sector.
• Innovation: Hep B will need a unique approach; just as hep C work does not mimic exactly what is being done around HIV. More hep B focus and understanding should lead to more innovation.
• Multidisciplinary workforce: The Strategy calls for “A strong multidisciplinary workforce of motivated, trained and regularly updated health professionals, community and peer-based workers.”
• Workforce retention: The Strategy notes that issues around funding and staff retention need to be addressed if we are to build the hep B workforce.
• Layered experience of hep B: Extra layers of stigma are more apparent with hep B because of culturally-based stigma and we cannot box people according to the most obvious element of their situation.

Closing the Gap at Yabun Festival 2019

Yabun is the largest one day gathering in recognition of Aboriginal and Torres Strait Islander cultures in Australia. It’s held annually on 26 January (Australia Day, aka Survival Day/Invasion Day), upon the traditional lands of the Gadigal people in Sydney, at Camperdown’s Victoria Park. Established in 2001, Yabun (meaning ‘music to a beat’ in Gadigal language) is a free event that features live music, a bustling stalls market, panel discussions and community forums on Aboriginal issues, children’s activities, and traditional Aboriginal and Torres Strait Islander cultural performances.

Hepatitis NSW was there this year with all other 414 Close The Gap* partner organisations to engage with the community. Staff and volunteers contributed to discussions and resource distribution to the many people attending our stall. The event proved a success with close to 150 resource bags being distributed, and many one-to-one interactive discussions being held.

*Hepatitis NSW, ACON, NUAA, SWOP and Positive Life – who are all based at 414 Elizabeth St, Surry Hills – work with overlapping communities and, in recognition of Aboriginal and Torres Strait Islander peoples health needs, formed the “414 Close the Gap Working Group” (414 CTG). This is a collaboration intended to maximise our impact in the work we do with and on behalf of Aboriginal and Torres Strait Islander peoples.

Pet Pics get hep C messages to homeless and disadvantaged people

Pet Pics is a fun and exciting new Hepatitis NSW project that promotes our Hepatitis Infoline. Several pet-related and housing/homeless NGO project partners are already involved. The project draws on research including an interesting report – Homeless and Connected: Mobile phones and the Internet in the lives of homeless Australians. We’ve also drawn on results from an internal survey taken through five NSPs in 2018.

What is Pet Pics? People text us a photo of their pet which we photoshop with a health promotion message turning it into a Pet Pic. We text it back and they can share the Pet Pic as often as the like with their friends. Every two months we send all entrants an SMS text asking for votes on the best recent Pet Pic. The winner is sent a voucher (by SMS text) for a $50 Coles gift card or mobile phone credit. Each Pet Pic also promotes one of our pet-related NGO project partners (several of which have a metro/rural presence). After several months, we hope that all people involved will know about all these valuable services: Pets in the Park [website] Ruff Sleepers [website] Way 2 Home [website] Each Pet Pic message will address one of several hepatitis C treatment related issues, including misconceptions and fears, and stigma. Pet Pics was launched in December 2018. In addition to the pet-related NGOs listed above, we have recruited the support and involvement of Northcott (housing estate), FaCS (Redfern office), City of Sydney (Homelessness project) and Matthew Talbot Hostel.

Men’s Sheds targeted for viral hep info

During December and January, Hepatitis NSW hosted two students from Western Sydney University – Mariam El Safadi and Amira Al Hellani – as part of their course placements. They were asked to plan a project to promote health and awareness of hepatitis B and hepatitis C.

After researching different target groups, they chose to focus on individuals who are part of men’s sheds. This was because men over the age of 40 are at risk of liver damage if they have hep B or hep C. They contacted various men’s sheds across NSW to see if they would be interested in receiving packages of Hepatitis NSW resources.

These resources include flyers, handouts, and posters about hep B and hep C, which would then be distributed to the members of the men’s sheds free of charge. Mariam and Amira contacted them via email and telephone. Some responded positively and were enthusiastic about the idea, while others were more initially hesitant. Overall, it was a very successful project.

The students felt that their placement at Hepatitis NSW was a new and enjoyable experience that allowed them to gain new skills in health promotion.

If you know of a Men’s Shed that would use this material please contact 1800 803 990.

New FINCOL poster on cleaning fits in prisons

As most readers might know, there are currently no NSP or medically-supervised safe-injecting facilities available within NSW prisons. This is even though many prisoners do inject drugs, and despite the fact that prisons are a significant place for transmission for hepatitis C and other blood borne viruses. Much has been written about the need for the access to harm reduction services within prisons, and Hepatitis NSW remains committed to advocating for this to happen – until then we must work with the limited options available to NSW prisoners.

This is where FINCOL comes in. FINCOL has replaced bleach as the cleaning fluid of choice in NSW prisons and is available to prisoners, via dispensing machines, for them to clean their cells but also, if required, injecting equipment, plus tattooing and piercing gear. When used correctly FINCOL will kill hep C, hep B and HIV. Unfortunately, many prisoners are not aware of this, nor are many aware of the right way to clean equipment. For this reason, Hepatitis NSW has recently developed a new FINCOL poster for distribution to prisons and prisoners. The poster aims to improve awareness in the effectiveness of FINCOL in eliminating hep C and other blood-borne viruses, and for cleaning fits and other related injecting, tattooing or piecing equipment.

Unlike most of our other resources, this poster is not available for order or public distribution. Instead it is only being internally distributed to NSW prisons for placement in clinics and beside FINCOL machines, and to prisoners through our information packs. The reason for the restricted distribution is that, for all people outside of NSW prisons, NSPs are the recommended way to obtain sterile injecting equipment. You can however check out the poster via our website >>>CLICK HERE.

Hepatitis NSW would like to thank: participants at the Compulsory Drug Treatment Correctional Centre for participating in focus testing for the poster; the Justice Health and Forensic Mental Health Network Harm Reduction Team for their input and support; the Harm Reduction Stakeholder Group for offering to distribute the poster in prisons; Corrective Services and NSW Ministry of Health for approvals; Jasol and Brenton Davies (manufactures and distributors of FINCOL) for offering to distribute and fix posters to all FINCOL dispensing machines in NSW prisons; and our wonderful Hepatitis NSW volunteers for laminating several thousand posters.