Using a unique and culturally sensitive approach, UNSW is helping the NSW Government to make contact with Indigenous people living with hep C and ensure they receive the treatment available, improving lives, preventing transmission, and helping to eradicate hep C in Australia by 2030.
The Challenge: Indigenous people with hep C are not being assessed or treated
Indigenous people are eight times over-represented in the population of people living with hepatitis C in Australia. Many Indigenous people living with hepatitis C are not seeking help from the medical community because of issues like shame, stigmas around hep C and drug use, and the inability of mainstream health services to provide information and support in culturally appropriate ways.
The old hep C treatment was long and arduous, and only 50% effective. A new treatment is available that is more than 90% effective over a shorter treatment period with much more manageable side effects. Based on the success of this new treatment, the WHO is aiming to eradicate hep C worldwide by 2030.
UNSW's solution: Evaluate and improve local health district services for Indigenous Australians
Carla Treloar and Melinda Walker, with the help of Indigenous consultant Aunty Clair Jackson, are evaluating the NSW Government’s hep C education and treatment programmes across local health districts in NSW. They initially evaluated two districts in Western Sydney and Nepean Blue Mountains in 2015, and based on the success of their work, commenced a State-wide rollout of their Deadly Liver Mob programme at the start of 2017 to an additional seven sites (Broken Hill, Dubbo, Kings Cross, Tweed Heads, Coffs Harbour, Grafton and Byron Bay).
Local health districts invite Indigenous people in for education and screening. Participants are paid $20 for their first contact, and $10 for each visit after for follow-up screenings for other infectious diseases like HIV. Carla and Melinda evaluate the program by talking with community members and health care providers with a focus on screening, testing, and treatment (if necessary). Aunty Clair interprets interview recordings for social and cultural sensitivities. Other data from clinics is analysed to measure attendance.
All Deadly Liver Mob activity is undertaken with respect and cultural awareness of the different histories and issues unique to each district. Calling on their Indigenous knowledge and expertise, the team is able to assess where the local system is working and where it isn’t, and what improvements are needed to reach more Indigenous people in the community. A report is delivered to the local health district and universal learnings are shared with other districts.
The Impact: Test and treat more Indigenous people living with hep C, prevent transmission
In the pilot project involving two districts in Western Sydney, more than 400 Indigenous people were educated about hep C, 300 were checked and 150 came back for results. Since the roll out began at the start of 2017, eight Indigenous people have been treated for hep C in one district alone.
Not only does this project significantly improve the lives of Indigenous people living with hep C and the lives of those around them, it prevents further transmissions occurring, reducing the cost to the medical system. With further funding, this project could be rolled out across Australia, contributing to the goal of eradicating hep C by 2030.
Researchers
Professor Carla Treloar is Director of the Centre for Social Research in Health and the Social Policy Research Centre at UNSW. Her research interests are c hepatitis C and injecting drug use. She is a Member of NSW Health Ministerial Advisory Committee on Hepatitis, and Associate Editor of Addiction, an International Journal of Drug Policy.
Melinda Walker is a Community Reference Panel Coordinator and Research Assistant for UNSW’s Centre for Social Research in Health.
L.Clair Jackson is the Aboriginal Mentor & Advisor to the Centre for Social Research in Health and the Social Policy Research Centre, UNSW.