World Hepatitis Day 2015 took place on Tuesday, July 28th. On this day, millions of people across the world called attention to the growing epidemic of this viral disease by discussing measures to eradicate viral hepatitis. I took part in this day by attending the World Hepatitis Day Press Conference on The Hill which used the platform to call for action s for increased prevention programs, elimination of viral hepatitis health disparities, and access to treatment, or in the case of Hepatitis C, a cure. The press conference was put on by The Hepatitis Appropriations Partnership, Hepatitis B United, and The National Viral Hepatitis Roundtable (NVHR) and was hosted by Ryan Clary, Executive Director of the NVHR. Congressional officials in attendance included Congressman Hank Johnson (D-GA), Congressman Mike Honda (D-CA), and Congresswoman Judy Chu (D-CA). These three members of congress have been champions for the eradication of viral hepatitis in America. Congressman Johnson, diagnosed with Hepatitis C in 1998 and cured in 2012 has dedicated himself to passing healthcare reform so all American can access and benefit from quality healthcare. Congressman Honda (a sponsor of my internship program - Health Career Connections) has strongly supported funding for Hepatitis B and C, and serves as the Chair of the Congressional Hepatitis Caucus. Congresswoman Chu has advocated for the
Congresswoman Judy Chu (D-CA) speaking at The 2015 World Hepatitis Day Press Conference
needs of Asian Americans and Pacific Islanders and given that they carry the highest burden of Hepatitis B in the nation, she has been a strong advocate for congressional funding for research and a cure. After the representatives spoke, two patient advocates shared their stories of how their lives were affected by hepatitis. Andrew Le, an IT administrator at AddoMed, lost his uncle from HBV in April. His uncle was living with HBV for over 50 years without knowing, and was diagnosed with stage 3 liver cancer. Dr. Alicia Suarez, lived with HCV for exactly 20 years, and just discovered she had been cured a few weeks ago. She currently researches and publishes on the patient experience for people living with hepatitis, and the issues they deal with concerning stigma, disclosure, and knowledge.
Following the press conference, I was fortunately able to attend a hearing next door on America's growing heroin epidemic under the House of Representatives' Committee on the Judiciary, Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. I am sure it was no coincidence that these two events happened on the same day. With 600,000 people addicted to Heroin and 90% of new cases of Hepatitis C belonging to people who inject drugs, it could not have been a more ideal time to talk about these issues facing America's citizens. The hearing was attended by Representatives Jim Sensenbrenner (R-WI), Judy Chu (D-CA), Bob Goodlatte (R-VA), Randy Forbes (R-VA), Trey Gowdy (R-SC), Raul Labrador (R-ID), and Mike Bishop (R-MI). I was greatly surprised to see how many people were lined up for this hearing, considering the hundreds of people lined up to see Secretary of State John Kerry at the hearing on the Iran deal next door. So, the witnesses at the hearing included Nancy Parr, Commonwealth Attorney in Virginia, Angela Pacheco, District Attorney in New Mexico, Jack Riley, Acting Deputy Administrator of the Drug Enforcement Agency, and Michael Botticelli, Director of the White House Office of National Drug Policy. The hearing began with addressing the current heroin problem in America. There were mentions of the sharp increases in overdoses, which is now the #1 cause of death due to injury - higher than homicide and motor vehicle accidents. The congressmen discussed the attractiveness of heroin; this included the increased potency of heroin drugs and the cost difference between heroin and prescription opiates. I believe the most important thing that was said multiple times during the hearing was that heroin knows no geographical boundary, and the epidemic transcends race, age, and class. There is no typical heroin user. I went onto a needle exchange van my freshman year of college and that is exactly what the people on the van said: they saw people from all walks of life addicted to heroin. I personally believe this fact is essential to the conversation on the heroin epidemic, as it can attract people from all backgrounds, beliefs, etc.
Michael Botticelli brought up that America should be treating the issue as a public health concern and not a criminal justice concern. Some resolutions include prescription drug monitoring on individuals that may be "doctor shopping", training for providers on prescribing prescription opiates, and syringe exchange programs to deal with the HCV epidemic. Most congressmen in attendance seemed to agree that the heroin epidemic needs to be fought with increased drug treatment and not with criminalization. Nancy Parr mentioned that users, incarcerated or not, should have access to treatment. There was conversation on the issue of recidivism and the lack of post-release programs for individuals out on parole to transition back into the community. Congressman Forbes actually discussed the use of Faith-Based Organizations to lower recidivism rates which I thought was incredibly thoughtful. However, it was evident that they still wanted to increase efforts at seizing heroin, taking down major drug trafficking organizations and street gangs, and in general decreasing the demand for heroin. Congressman Goodlatte in particular seemed very concerned with the relationship between violence and heroin trafficking. Congressman Gowdy recommended that the mandatory minimum for heroin possession needed to be reformed so that a smaller possession of heroin can guarantee a prison sentence. Angela Pacheco discussed an interesting program that New Mexico was taking on, called LEAD. The program essentially involves law enforcement directing heroin users into treatment when they arrest them, and if they complete the application into drug treatment, no charges will be filed. I personally thought this was a phenomenal intervention that not only fosters trust and respect between the community and law enforcement, but provides PWIDs with the treatment they need without punitive measures.
Overall, the attendees at the hearing were very aware that aggressive measures needed to be taken to end the heroin epidemic in America. America needs a fluid, coordinated, and collaborative response that is radically different from the measures taken to stop the crack-cocaine epidemic decades earlier.
Grace Osagie is an undergraduate student intern at the Forum for Collaborative HIV Research. She is currently pursuing a B.A. in Public Health Studies at Johns Hopkins University.She is also involved with Charm City Clinic, a local non-profit health resources clinic in East Baltimore and deals with issues concerning health insurance and access to care for residents in Baltimore.