Hepatitis C Fight Hinges on Prisons

INMATES AND THEIR advocates are pushing for legal and political fixes to fight hepatitis C, a public health problem experts say can’t be solved in the U.S. overall without first tackling it within prison walls.

The hepatitis C virus attacks the liver and can turn deadly: Research shows it was associated with more fatalities in 2013 than 60 other infectious conditions combined – HIV and tuberculosis included. And though the disease affects 1 percent of the general population, according to the Centers for Disease Control and Prevention, the prison prevalence is thought to be around 17 percent.

When infected and formerly incarcerated people re-enter society, they can spread the blood-borne virus through intravenous drug use with dirty needles and, less often, sexual contact. Linked to the opioid crisis, hepatitis C spiked by more than 200 percent in 30 states since the period 2010-2014, Yale University researchers note in a 2018 follow-up article to a landmark study they published two years earlier.

“Since the prison system has the highest concentration of people living with the virus, failure to scale up treatment in prisons dooms any effort to eliminate hepatitis C in America,” the 2018 article states.

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In Florida, a federal judge in Tallahassee released a strongly worded order in 2017 requiring inmate treatment. The Florida Department of Corrections “must move with ‘alacrity,'” U.S. District Judge Mark Walker wrote. “This Court will not tolerate further foot-dragging.”

Walker’s order put Florida at the head of the pack in terms of leaving a legal landmark about the future of care for inmates with hepatitis C. “It was a big win for us,” says Randall Berg Jr., president emeritus of the Florida Justice Institute in Miami and the inmates’ class counsel.

Indeed, prisoner advocates in other states are watching Florida, where Walker, chief of the U.S. District Court for the Northern District of Florida, is expected to make permanent his 2017 temporary injunction ordering hepatitis C treatment.

“We’ve followed the Florida case closely, and cited the court’s reasoning in our briefs. It’s broken important ground,” says Katz of Indiana University, who’s serving as co-counsel for the Indiana class action.

A Florida inmate won’t soon forget how hard his lawyers and Florida Justice Institute staff worked to obtain the drugs that cured his hepatitis C.

“I get out of prison in four years and I intend to live a healthy, thankful life, paying back andforward,” Benjamin Kennedy wrote to Berg from Okeechobee Correctional Institution. “Y’all truly saved my life. And I’m grateful to y’all beyond words.”

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