Éliminer l’hépatite C en Europe : rapport sur la mise en œuvre des politiques pour les personnes qui s’injectent des drogues - 2024

Le suivi de la société civile par le C-EHRN identifie des progrès nécessaires mais inégaux en matière de traitement et d’accès, dénonçant des obstacles persistants liés au financement, à la législation, à la stigmatisation et à la volonté politique. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous.

The latest report in the 2024 Civil Society Monitoring of Harm Reduction in Europe series explores developments in hepatitis C care for people who inject drugs, based on observations from C-EHRN focal points in 40 cities across 35 European countries. The findings point to trends such as expanded access to direct-acting antivirals (DAAs), ongoing healthcare stigma, and disparities in harm reduction funding. To gain further insights into this year’s report, we spoke with primary author Tuukka Tammi. Download the publication and read the interview below.

Compared to last year’s findings, what has changed the most in hepatitis C care for people who inject drugs?

The biggest shift is the record number of cities in the survey, giving us again a broader view of what’s happening across Europe. Forty cities across 35 European countries is a significant number. Most cities are actively encouraging treatment for people who inject drugs, and DAAs are available everywhere now, but restrictions still prevent universal access. And stigma in healthcare remains a major hurdle.

Were there any surprises in this year’s data—either positive or concerning?

A big win is that free HCV testing is now available in every city, and non-invasive diagnostics with Fibroscan® is more common. But there are still serious challenges. Harm reduction services continue to struggle with funding, and bureaucratic barriers like slow insurance approvals delay treatment.

This year’s report includes more participating cities than ever before. Did this expanded dataset bring new insights?

Definitely. The larger dataset highlights stark differences between cities making good progress and those falling behind. Some have strong policies, easy access to treatment, and well-funded harm reduction, while others still face major gaps due to restrictive policies and lack of funding. As we know more broadly, there are major divides in access to harm reduction services across Europe.

Some cities are making strong progress toward the 2030 HCV elimination goal, while others are lagging. What are the key factors that explain these differences?

Cities moving forward typically have well-funded harm reduction, fewer treatment restrictions, and national policies that prioritize HCV elimination. When treatment is accessible, and stigma is tackled, things improve. But in cities with funding cuts, excessive red tape, and discrimination in healthcare, progress stalls.

Stigma and discrimination remain a major issue in HCV care. What new insights does the 2024 report offer on this challenge?

The report makes it clear that stigma is still a huge issue, especially in general healthcare, gastroenterology clinics, and prisons. One major problem is that many healthcare providers lack training on HCV, leading to unnecessary referrals and delays in treatment. Prescription restrictions for DAAs add another layer of difficulty. If stigma isn’t tackled through policy changes and provider training, it will continue to hold back progress.

The report mentions monitoring schemes for people who inject drugs after their HCV diagnosis and treatment. How well are cities doing in this area?

It’s mixed. Just over half of the cities have structured post-treatment follow-up, which helps prevent liver damage and reinfection. But many still lack proper monitoring systems, making it easy for people to fall through the cracks.

This year’s report also examines access to hepatitis C services for people who use drugs but don’t inject. What are the key takeaways from these findings?

People who inject drugs get most of the attention, but those who use drugs in other ways are often overlooked. The report shows that access to testing and treatment for this group varies widely.

What are the top recommendations from this year’s report for policymakers and harm reduction organisations?

Mostly the same as in previous years. HCV care needs to be easier to access. Funding for harm reduction has to be protected—when services like needle exchanges and opioid agonist therapy are cut, transmission rises. Bureaucratic delays in treatment must be reduced, and healthcare providers need better training to diagnose and treat HCV without stigma. Free testing should be expanded, and governments need clear elimination strategies. Integrating harm reduction into mainstream healthcare is also key to breaking down barriers.

Based on this year’s findings, what should we be paying close attention to in 2025?

Harm reduction funding is a big concern—if cuts continue, progress could backslide. We also need to watch how policies evolve. Are they making treatment easier or harder to access?