How to Eliminate Hepatitis C Between People Who Inject Drugs in Community Services and Prisons in Catalonia
The Spanish National Health System, with devolved powers to autonomous communities such as Catalonia, faces significant challenges in controlling viral infections like hepatitis C (HCV) among vulnerable groups, particularly people who inject drugs (PWID), where prisons serve as crucial intervention sites. Catalonia’s health authorities have implemented strategies to combat HCV, including direct-acting antiviral (DAA) treatments and harm reduction programmes within both community and penitentiary settings. However, substantial barriers persist in achieving full treatment uptake and clearance among PWID subpopulations.
Main body
A review, published in Harm Reduction Journal, discussed the Catalonia’s current HCV programmes and explored intervention proposals needed to achieve WHO elimination targets. Catalonia has implemented a comprehensive HCV plan, particularly targeting PWID, that has proven effective through enhanced screening, universal treatment access, and harm reduction, though structural and social barriers remain due to fragmented health and social systems.
Conclusion
Advancing towards HCV elimination requires strengthened inter-organisational coordination, integrated social and health services, simplified care pathways, enhanced screening, professional training, targeted research, measurable goals, culturally appropriate and participatory prevention strategies, and a comprehensive, people-centred approach. This is particularly important in prisons, where universal screening, adapted caring processes, harm reduction, and opioid substitution treatments (OST) are essential. Considering the social determinants of health perspective, it is essential that policies and programs are structured to reduce structural inequities and vulnerabilities, thereby promoting equity in both access to prevention, care, treatment, and health benefits across all population groups, particularly those most affected.