This blog post was authored by Dr. Daniel Lising, Research Assistant for the O’Neill Institute’s Hepatitis Policy Project. Daniel is a graduate of Georgetown University Law Center with an LL.M in Global Health Law.

As the scourge of the opioid crisis continues, an often-overlooked consequence is the increased proliferation of blood borne illnesses such as hepatitis C. This disease which was previously prevalent among baby boomers who received blood products during the time when the disease was not well understood has now had a resurgence. This resurgence comes amidst the increasing number of injection drug users who shares contaminated needles.

In earlier years, a diagnosis of hepatitis C was a sentence which carried with it the eventual development of deadly liver cirrhosis and liver cancer or hepatoma. However, with the invention of a new class of highly effective drugs known as direct acting antiretrovirals (DAA), this disease has shifted from a death sentence to an illness with a definite cure.

Unfortunately, this sunny development came with a silent shadow. The course of treatment was out of reach by the populations which needed it most such as inmates in correctional facilities, injection drug users and people in poverty due to its prohibitive cost. This was further aggravated by restrictions in Medicaid coverage which only covered individuals which have already suffered some degree of liver damage, or imposed other limitations to access.

This state of hepatitis C policy needs to change. Treating patients with DAAs during the period where there is no or minimal liver damage prevents the continuation to complicated liver conditions such as liver cancer or liver cirrhosis later in life, which cost significantly more to treat. States also need to remove or revise restrictive laws which hinder needle exchange programs that could significantly decrease chances of transmission of the disease among injection drug users.

The efforts of California Governor Edmund Brown Jr. in expanding coverage of Medi-Cal to treat all stages of the virus, as well as treating inmates in the state’s prison system offers a model for hepatitis C policy. Addressing root causes of poverty and homelessness including mental illness and drug addiction is also a vital component of eradicating hepatitis C transmission as these segments of the population are especially vulnerable to the disease.

Although the elimination of the illness is still a ways off, creating a policy that saves to decrease the chances of contracting the disease is an important first step to controlling the silent killer that is hepatitis C.