Universal access for treatment of Hepatitis C, including the access of active drug users who inject drugs

According to behavioural research carried so far among drug users, around 75% of the tested active drug users who inject drugs are HCV positive in Republic of Macedonia. Despite knowing this fact, active drug users do not have access to treatment of Hepatitis C, since there is a precondition that they have to fulfill - they have to have abstained from drugs for at least 12 months and/or to be enrolled at some of the drug dependence treatment programs. As a main reason for the existence of this precondition, health professionals point out the risk of possible reinfection, which would also mean wasted resources and unnecessary spendings.
 
This question caused heated discussion and opposed positions among participants on the second day of the conference ““Availability of Hepatitis C treatment to drug users in the Republic of Macedonia – good practices and challenges”. For more information, watch the related video.
 
Part of the health professionals were against the inclusion of active drug users who inject drugs in the treatment, arguing that there was a high risk of re-infection and part of the participants thought that they should be included in the treatment because they were the driving force of the epidemics of Hepatitis C and this was one of the ways to prevent it from spreading further. 
 
Dependence on illegal drugs is a medical condition which should be treated as a public health issue on ethical grounds that require implementation of effective measures to prevent infectious diseases and to reduce the harm associated with drug use. Effective measures to prevent infections exist, but they are either not available or are not available for most of the people who need them. 
 
According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the spread of infections associated with injecting drug use, are kept under control during the last decade in some European countries, and infection rates are falling, most as a result of the combination of behavioral change in the population of drug users, improving the prevention services, vaccination and treatment of infectious diseases. 
 
Based on evidence and expert opinion, antiviral therapy should be provided (based on clinical indications) for all those infected with HIV, HBV or HCV. Universal access is recommended for all treatments, including access for active drug users who inject drugs.
 
Studies show that treatment of Hepatitis C among people who inject drugs show identical results when compared to those of the general population who does not injected drugs if the existing treatment was accompanied by adequate support.