Queensland prisoners are stuck on a “merry-go-round” of hepatitis C transmission because the government is failing to deliver harm reduction programs needed to eliminate the virus, advocates say.
Queensland, along with other Australian states and territories, has committed to the elimination of hepatitis C by 2030, in line with global targets set by the World Health Organization.
But community support worker Tegan Nuckey says a lack of funding and delays in programs means organisations are currently chasing their tails trying to stamp out the virus.
“We can treat and test for hepatitis C until the cows come home, but we still need to be able to provide … harm reduction education [and] syringe programs,” she said.
“Otherwise, we’re just continuously treating people for hepatitis C who are being reinfected in the prison system.”
Hep C is a blood-borne virus that mostly spreads through the use of unsterile or shared needles during intravenous drug use. If left untreated, it can result in liver damage, cirrhosis and liver cancer.
Advocates say prisons are a hotbed for hep C transmission, with data showing 20% of inmates in Australia are chronically infected with the virus.
In 2021, about 73% of people who were treated for hepatitis C in Queensland were in the state’s prisons.
This figure represented 47% of the national total for people who received hepatitis C treatments in a correctional facility.
Nuckey said one of her clients was treated for the virus three times in the community after contracting it in prison while sharing syringes.
She said another man was unable to access the state’s opioid substitution treatment program for several months, despite disclosing that he was using illicit substances while incarcerated.
“That person put in continuous forms to try and get on the program saying this is part of my parole conditions and I need to be stable on this program before release,” she said.
“They were released without being started on the program [about a week ago] and there was not anything to follow up.”
The founder of not-for-profit Kombi Clinic, Dr Jonathan O’Loan, said his organisation was finding 17% of those tested in Queensland prisons were coming back positive for the virus.
He said “it’s a reality” that drugs and injecting equipment were being used in Queensland prisons and so access to healthcare needed to be equal to what’s provided in the community.
“We did a great job early on in terms of … eliminating hepatitis C pockets, but we’re not doing enough if we’re going to reach 2030 targets,” he said.
“I think there are many aspects of Queensland Health that need improved funding and improved services.”
The chief executive of Micah Projects, Karyn Walsh, said her organisation also tests homeless and marginalised communities for hepatitis C. She said drug use needed to be seen as a health issue rather than one of law and order.
“Marginalised populations like homeless people coming out of prison, people in prison, they all need access to proper testing and treatment for hep C,” Walsh said.
“There needs to be a look at why aren’t people getting the [opioid] substitute programs because … they’re entitled to healthcare while they’re in there.”
To date, no Australian jurisdictions provide a needle syringe program in correctional centres. Queensland state Greens MP Michael Berkman said there had been “political resistance” to such programs.
“Shielding our eyes and pretending there are no needles or drugs in prison won’t save anyone,” Berkman said. “In fact, it’s created a hep C crisis in Queensland prisons.”
Berkman said prisoners have no access to Medicare, meaning they are wholly reliant on the state government for their healthcare.
“The state government needs to properly fund harm reduction programs in Queensland prisons, with access to clean injecting equipment, condoms and opioid substitution therapy,” he said.
A Queensland Health spokesperson said the department “continues to educate, screen, test and treat people for the hepatitis C virus and other blood-borne viruses in all of the state’s correctional facilities.”
The spokesperson said they work in partnership with Queensland Corrective Services to “disinfect equipment that might puncture skin such as needles, tattooing equipment, shaving implements such as Fincol or powdered bleach.”
They said opioid substitution treatment programs were made available across Queensland’s correctional facilities from mid-2022 and were supported by hospital and health services.
Guardian Australia understands that not all facilities have access to the program and the rollout is ongoing.
“We will continue to monitor and evaluate the program to ensure its future success in minimising harm to people who have been users of opioids,” the spokesperson said.
