Through the Find the Missing
Millions campaign, we are
highlighting best practice and
innovations in screening and
testing so that other organisations
can learn and develop their
national activities. Each month
we profile a successful diagnosis
initiative in hepVoice. This
month, we are highlighting the
efforts of the Canadian Society
for International Health and
Correctional Service Canada.
Raising Awareness in
Canadian Prisons
As is the case across much of the
world, the prisoner population in
Canada suffers disproportionately
from viral hepatitis. In 2005,
around 29% of federal prisoners
in the Canadian prison system
were known to be infected with
hepatitis C. The prevalence of the
virus amongst prisoners can be
attributed to many incarcerated
people having a history of injecting
drug use.
However, the lack of awareness
about viral hepatitis presents a
barrier when trying to address
the hepatitis epidemic in prison
populations. Each year, World
Hepatitis Day (WHD) provides an
opportunity to raise awareness of
the prevalence of viral hepatitis,
reiterate the crucial importance of
testing and treatment and break
down the barriers to elimination.
Since 2012, the Canadian Society
12 hep Voice JANUARY 2019
for International Health (CSIH) has
organized a World Hepatitis Day Art
Contest for federal inmates across
Canada, doing so in partnership
with Correctional Service Canada
(CSC) and with support from Gilead
Sciences Canada.
With both male and female
categories, the objectives of the
contest in 2018 were to increase
awareness about hepatitis and
encourage inmates to learn their
hepatitis status by getting tested.
These objectives were in keeping
with WHD 2018’s theme: “Finding
the Missing Millions: Breaking
barriers to diagnosis”.
Examples from
around the world
The high concentration of high-
risk groups in the prison system
provides a golden opportunity
to address one of the main
barriers to elimination: the
lack of easily accessible testing.
Correctional facilities have the
ability to ensure that each prisoner
receives hepatitis B vaccination or
completes a full course of hepatitis
C treatment (which takes around
8-12 weeks) without falling off the
radar of health professionals.
In Canada, inmates of federal
correctional institutions can
access hepatitis treatment. CSIH
were pleased to report that in
2018, the Art Contest contributed
to an increase in diagnoses and
a subsequent increase in the
number of people receiving the
treatment that they need. Securing
this relatively early diagnosis and
treatment in the prison system is
cost effective, having the potential
to prevent more expensive and
drawn out treatment costs once
the prisoners are released.
When treating viral hepatitis in
prisoner populations, the main
barrier to diagnosis and treatment
reflects the main barrier amongst
non-prisoner populations: a lack
of public knowledge about the
disease. Initiatives such as the CSIH
Art Contest are a refreshing and
original way to address this key
barrier and should be applauded;
the most sincere appreciation of
these grassroots initiatives would
come, however, in the form of
robust financing plans and an
aggressive, committed approach to
early diagnosis all year round.
“The objectives of
the contest in 2018
were to increase
awareness about
hepatitis and
encourage inmates
to learn
their status”
hep Voice
JANUARY 2019 13