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Integrating HCV and HIV services improves HCV testing and awareness among people who inject drugs in India: Findings from a cluster randomized trio;
  Sunil Solomon
Reported by Jules Levin
Global Heoatits Summit June 15 Toronto
This model and its study is not new. Here in the USA we have many clinics similar to this and have for years, the concept is not very new, integrated HCV services into a public health clinic, a needle exchange office or an HIV clinic. And the concept here in the USA is very well accepted. The study is I guess a new entry into India and of note started in 2012 before DAAs, the results report 7% increase in HCV Ab+ awareness. The study was funded by the NIH and the study investigators must be applauded for their commitment to the project and to HCV in India where in this presentation they discuss how big the HCV epidemic among IDUs in India is, much bigger than in many Western countries. The problem here in the USA is not a shortage of good ideas. When I designed & funded the NYC Check Hep C project it was at that time the first major city HCV screening, linkage & care & treatment project. It failed only because it was not implemented very well by NYC and because clinics were not prepared to treat IDUs for HCV, but times have changed & NYC DOH and everybody has learned from mistakes. So the problem here in the USA why elimination programs are not being implemented anywhere is because of the resource intensive commitment costing a lot of money that state & federal officials do not want to spend and the lack of political will to do this, its not like HIV although HCV is curable & not a lifetime endeavor or cost. Until states and/or the federal govt decide to commit to a costly elimination program. a full program which requires much in services, we will not eliminate HCV, maybe in 20 years. It remains all too easy for a state or federal official to not respond to this HCV problem, unlike in HIV when in the early days activists were HIV+ and sick and stormed government offices and put o =n loud in your face confrontations but we do not have that today in HCV. As it is now the resource commitment is too great and even in states where there is a little bit of commitment to make a little progress there still is no full commitment to eliminate HCV. A full elimination program requires a full list of services and lots of costs, until we have this there will be no elimination. Jules Levin, NATAP















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