1 Background It is estimated that 71.1 million people are living with chronic hepatitis C virus (HCV) infection globally, including an estimated 6.1 million people with recent injecting drug use. Restrictive drug policies and criminalization of drug use have many unintended implications for harm reduction, HCV prevention and linkage to care for people who use drugs. Efforts to address HCV elimination goals will require addressing restrictive drug policies and improvements in health service provision for people who use drugs. The International Network on Hepatitis in Substance Users (INHSU), a non-profit, member organisation dedicated to scientific knowledge exchange and advocacy on hepatitis care for people who use drugs, and UNITE, a non-profit, non-partisan, global network of parliamentarians committed to the elimination of HIV/AIDS, viral hepatitis and other infectious diseases, have collaborated to deliver a Joint Action Policy Day on integrating drug user health policy and hepatitis C prevention and treatment. Aim Motivation of policy champions in drug user health and hepatitis C elimination, globally. Joint Action Policy Day Discussion Objectives

• Highlight global best practices in drug user health and harm reduction policy

• Highlight global best practices and policies in prevention and treatment of HCV infection

• Discuss what is required for policy change and expanding best practice

• Strategize actions for developing best practice policy implementation

Outcome The organisers would like to thank Open Society Foundations for their support of the event, Médecins du Monde for their invaluable contribution White paper led by parliamentarians and other stakeholders summarising current into the program, and the Australasian Society for HIV, Viral Hepatitis and international best practice in both drug user health policy and hepatitis C prevention, Sexual Health Medicine (ASHM) for their collaboration the development of treatment and care policy and setting out proposed actions to further advance policy the program, facilitation of speakers, and organisation of the event. in these areas.

2 3 PROGRAM 2:00pm Arrival and registration Best Practices and Policies to Enhance HCV Prevention and Care Chairs: Opening Annette Verster, WHO 2:30pm Welcome Portuguese Minister for Health Philippe Duneton, UNITAID

2:35pm Introduction Jason Grebely, INHSU, The Kirby 5:00pm Practices and policies that have led Gregory Dore, The Kirby Institute, Institute, UNSW Sydney to enhanced HCV prevention and UNSW Sydney care in Australia 2:40pm A Global Review of Injecting Sarah Larney, National Drug and Drug Use, HIV, Hepatitis C, Harm Alcohol Research Centre, UNSW 5:10pm Practices and policies that have led Mariam Jashi, Parliament of Reduction Coverage Sydney to enhanced HCV prevention and Drug User Health and Hepatitis C Care in Portugal care in Georgia

2:45pm Overview Ricardo Baptiste Leite,UNITE 5:20pm Perspective from the community Representative, World Hepatitis Alliance Network, Portuguese National Parliament 5:30pm Discussion and questions 3:00pm Policy Perspective: João Goulão, General Directorate Decriminalization and Harm for Intervention on Addictive Moving Policy Forward and Expanding Best Practice Reduction in Portugal Behaviours and Dependencies Chair: Ricardo Baptiste Leite 3:10pm Clinical Perspective: Hepatitis C Rui Tato Marinho, Hospital Santa Care in Portugal Maria 6:00pm Parliamentarian Panel Discussion: What is required to create policy change in drug user health and HCV? 3:20pm Community Perspective: Drug User Luis Mendão, GAT/Coalition Plus Health and Hepatitis C Care in 6:50pm Closing Summary Portugal 7:00pm Meeting End Best Practises and Policies to Enhance Drug User Health Chairs: Celine Grillon, Médecins du Monde Daniel Wolfe, Open Society Foundations 3:30pm Practices and policies that have led Mark Tyndall, British Columbia to enhanced drug user health in Centre for Disease Control Canada

3:40pm Practices and policies that have led Yatie Jonet, Malaysian AIDS to enhanced drug user health in Council Malaysia

3:50pm Perspective from the community Judy Chang, International Network of People who Use Drugs

4:00pm Discussion and questions

4:30pm Break

4 5 Ricardo Baptiste Leite Philippe Duneton Ricardo Baptiste Leite is a Medical Doctor (ID-trained), Dr. Duneton was instrumental in the 2006 creation a Member of the Portuguese National Parliament and of Unitaid. His career has focused on HIV/AIDS, infectious City Councillor of Cascais. He is the President of ‘UNITE – & tropical diseases and public health. He was twice Parliamentarians Network to End HIV/AIDS, Viral Hepatitis advisor to Bernard Kouchner of France’s Ministry of and Tuberculosis’. One of the six people to be awarded Health, practiced medicine in the Infectious Diseases globally as a ‘HCV Change Maker’ by ‘The Economist’ in Department of La Pitié Salpétrière hospital in Paris and acknowledgment of leadership in the field of hepatitis C. headed the mission against HIV/AIDS and harm reduction He is the Head of Public Health at Catolica University of for l’assistance publique, Hôpitaux de Paris. He also led Portugal, and Coordinator of the Sustainable Healthcare the French regulatory agency for medicines and health Unit at NOVA Information Management School. Ricardo is a products and chaired the board of the European Medicines PhD candidate at Maastricht University in the Netherlands. Agency. He has undertaken Post-graduate studies at Johns Hopkins University, Harvard Kennedy School and Harvard Medical School. Ricardo is the founder of ‘CREATING HEALTH – João Goulão Research and Innovation Funding’ and Co-founder of the João Goulão is currently the Portuguese Drugs and ‘Estoril Conferences’, and the main author of the book Alcohol National Coordinator and Director General of the ‘Citizenship for Health’. Intervention on Addictive Behaviours and Dependencies General Directorate (SICAD). He was Chairman of the European Monitoring Centre on Drugs and Drug Addiction Judy Chang (EMCDDA) from 2009 to 2015 and he has a long experience Judy has worked in the HIV and community health in the addictions field at international level. and development field for eight years, across areas A medical doctor by profession, Dr. Goulão has over 20 of programme management, resource mobilisation, and years’ experience in drug-related issues, working in this communications. She has been increasingly involved in field since 1987 as a general practitioner and devoting harm reduction, community mobilisation and drug policy his professional life since then to drugs and health. Dr. work, particularly in regards to women who use drugs. She Goulão was a member of the Portuguese Committee which has worked across India, China, and Thailand. She holds a prepared the report that formed the basis of the first Master’s degree in International Development and is an Portuguese Drug Strategy, and included proposals regarding MPhil Candidate at the National Drug Research Institute, decriminalisation. Australia.

Gregory Dore Professor Dore is Head of the Viral Hepatitis Clinical Research Program at the Kirby Institute, UNSW, Australia, and Infectious Diseases Physician at St Vincent’s Hospital, Sydney, Australia. He has been involved in viral hepatitis and HIV epidemiological and clinical research, clinical care and public health policy for 20 years.

6 7 Jason Grebely Yatie Jonet Jason Grebely is an Associate Professor and NHRMC Yatie is a drug user living with Hepatitis C, has spent time Career Development Fellow in the Viral Hepatitis Clinical in prison and detention centers, a single mother, and an Program at the Kirby Institute, UNSW Australia. Jason advocate for rights to health through harm reduction and completed his BSc in Biochemistry and Molecular Biology drug policy reform movements. Yatie is a Focal Person and his PhD in Pharmacology at the University of British for the Harm Reduction Program, the People Who Inject Columbia in Vancouver, Canada. He then completed a Post- Drugs Project, Hepatitis C Project, and Drug Policy Reform Doctoral Fellowship in Clinical Epidemiology at UNSW Movement in Malaysia. She works passionately in planning, Australia. negotiating, advocating, coordinating meetings at various Jason’s research has contributed to understanding the levels, sensitization workshops, national review planning epidemiology and natural history of HCV; evidence and community mobilization. She also works closely with supporting the care of HCV among PWID; the development strategic partners and allies with a mission of creating an of international recommendations for the management of enabling environment for people who use drugs to access HCV among PWID; and has informed state-based, national, health, treatment and care services without stigma and and international strategies for viral hepatitis. He has discrimination. published 120 peer-reviewed publications and has current research funding from the Canadian CIHR, Australian NHMRC and the US NIH. Jason is an Associate Editor for the Sarah Larney International Journal of Drug Policy, PLOS One and BMC Sarah Larney is a Senior Research Fellow at the National Infectious Diseases. Drug and Alcohol Research Centre, University of New South Wales, Australia. Her work focuses on injecting drug use and related harms, including infectious diseases and Mariam Jashi intersections with the criminal justice system. Dr. Jashi is the Chairperson of Education, Science and Culture Committee of the and member of the Parliamentary Health Committee. Dr. Jashi is the President of the global Leading Group on Innovative Financing for Development for 2017-2018, and the President of the global Rui Tato Marinho Leading Group on Innovative Financing for Development Prof. Rui Tato Marinho is an Associate Professor at the for 2017-2018. Deputy Minister of Labour, Health and Medical School of Lisbon, Portugal. He is the Head Social Affairs of Georgia from 2012-2014, Dr. Jashi was of Department of Gastroenterology, Hepatology at in charge of the public health portfolio, including the the Hospital de Santa Maria and a United European Hepatitis C Elimination initiative. Dr. Jashi brings 20 years of Gastroenterology- Elected Member of the General management and consultancy experience in humanitarian Assembly. Prof. Marinho was the Vice President of the and development programmes from across 26 countries. Portuguese Society of Gastroenterology from 2013 -2019, During 11 years of work with UNICEF she has leveraged and the President of Portuguese Board of Hepatology over US$ 100 million from the Global Fund, GAVI, UNITAID, from 2013 – 2015. He is a Fellow of the European Board of USAID and other development partners for 19 countries Gastroenterology and Hepatology, the American Association of sub-Saharan Africa, Asia, CEE/CIS and Middle East. for the Study of the Liver Diseases, and an Advisor to the Mason Fellow of Harvard University and graduate of Lund European Liver Patient Association Governing Board. Prof. University and University College London programmes. Dr. Rui Marinho was awarded the Medal of Merit of Portuguese Jashi holds MPA from Harvard University, MD from AIETI Medical Association in 2015, and has had 91 papers indexed Medical School and MPH from State University. in PubMed including the New England Journal of Medicine, Gastroenterology and Liver International. 8 9 Mark Tyndall Daniel Wolfe Dr. Mark Tyndall is the Executive Medical Director of Daniel Wolfe is director of International Harm Reduction the BC Centre for Disease Control and Professor at the Development (IHRD) at the Public Health Program of the UBC School of Population and Public Health. He is an Open Society Foundations, which works in Africa, the infectious diseases specialist with a focus on urban Americas, Asia, and Eastern Europe to support the health health and addiction. His career awards include the and human rights of people who use drugs. Prior to joining Michael Smith Foundation for Health Research Senior the Open Society Foundations, Wolfe was a community Scholar Award and the Ontario HIV Treatment Network scholar at Columbia University’s Center for History and Applied Research Chair. He is an author on over 250 peer- Ethics of Public Health, a recipient of the Revson Fellowship reviewed publications, with a focus on HIV and Hepatitis awarded to individuals who have made a substantial C care and prevention, harm reduction, and public health contribution to the city of New York, and the director of implementation research. He was co-lead investigator on communications at GMHC, the largest and oldest AIDS NGO the evaluation of Insite, North America’s first supervised in the . Wolfe is an expert on the intersection injection site. Dr. Tyndall is a strong advocate and leader of HIV and drug policy, a member of the UN’s Strategic for public health in Canada and has fostered a number of Advisory Group on HIV and injecting drug use, and the community-based collaborations that have led to health author of book chapters and articles in peer-reviewed and policy changes. popular publications including the International Journal of Drug Policy, the Journal of the American Medical Association, the Lancet, the Nation, and the New York Annette Verster Times Book Review. Wolfe holds MAs in history and in Annette Verster works as the technical lead on key public health from Columbia University and a BA in Arabic populations at the WHO/HIV department in Geneva. She language and literature from Princeton University. has worked in the field of HIV for many years both in policy development, research and implementation. At WHO she developed the normative tools and guidelines on HIV and viral hepatitis for key populations. Annette continues to advocate for a public health response for key populations at global, regional and national level. An important part of these efforts are geared towards supporting countries to implement the recommended evidence based programmes and in setting national targets and monitoring progress along the cascade.

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