Journeys to Wellness: Prairie Hepatitis C Roadmap
The time to change the hepatitis C landscape in the Prairies is now!
Hep C is curable with highly effective oral treatments. With these medical advancements, what is now needed are investments and policies that support easy and equitable access to testing, treatment and care. While curing hep C is achievable, this report emphasizes that until the social, economic and personal wellness factors are considered, any plan narrowly focused on medical treatment will (and consistently does) fail.
Background
Each participant in the sharing circles painted a rock to connect with their creativity and make a visual contribution.
In 2019, CanHepC published the Blueprint to inform hepatitis C elimination efforts in Canada, offering evidence-based strategies to help Canada meet the World Health Organization’s goal of eliminating hep C by 2030. Recognizing the unique jurisdictional health care structures in Canada, Journeys to Wellness: Prairie Hepatitis C Roadmap was developed from 2022 to 2024 to address the specific needs of Manitoba, Saskatchewan and Alberta. This Roadmap aims to:
- Assess the current landscape of hep C prevention, diagnosis and treatment, identifying progress and existing gaps
- Uncover key barriers and enablers to effective hep C care and viral suppression
- Establish consensus on strategic priorities for improving hep C wellness across the Prairies
Resources
Journeys to Wellness: Prairie Hepatitis C Roadmap
The philosophy behind this report is that people with lived/living experience (PLE) are critical subject matter experts. Any wisdom toward developing a Roadmap to hep C wellness must begin and end with them. This work therefore included consulting over 60 individuals (over 25 of which were PLE) and several community organizations. The resulting nine themes, priority messages and opportunities for change were driven and validated by stories of experience and enhanced by powerful quotes and imagery.
PLE guided and enriched our work from the start. Among them were individuals both young and old, some who had hep C over 40 years ago, others with currently active infections and a wide variety of people across the 2SLGBTQ+ community. They shared their wisdom and words in sharing circles and in various roles. Each participant painted a rock to connect with their creativity and make a visual contribution. Images of their creativity are included throughout the roadmap, as this work is centred on and dedicated to these people.
Hep C Elimination Efforts in the Prairies
Despite notable advancements in the Prairie provinces, many challenges remain. The Roadmap provides a summary of what is working, what is not working and identifies opportunities for change across Alberta, Saskatchewan and Manitoba to address hep C.
Alberta
There has been significant progress towards hep C elimination in Alberta. The reported hep C rate in 2021 stood at 14.7 cases per 100,000 population, notably lower than the national rate of 19.7 cases per 100,000 population. For the Alberta summary, click here.
Saskatchewan
Saskatchewan contends with high rates of hep C, with a reported rate of 38.3 cases per 100,000 population, which is almost double the national rate. The 20% reduction in new cases between 2015 and 2019 fell short of the 30% target reduction. For the Saskatchewan summary, click here.
Manitoba
Manitoba continues to grapple with the highest rates of hep C in the country, with a reported rate of 42.3 cases per 100,000 population in 2021, exceeding the national rate of 19.7 cases per 100,000 population. The new cases reported between 2015 and 2019 increased by 85%, which fell significantly below the targeted reduction of 30% by 2020. For the Manitoba summary, click here.
Stories and Community
How we talk about this needs to change. Stigma is there because of how we talk about it. We got to frame it like just another health condition that can be treated. Frame it as health messages, wellness messages. Not stressful, not shameful, not dirty. Frame it in a relaxing way; light, hopeful.
After treatment, it was like I had a new body.
We need to educate health professionals early. It’s going to be years to get there. We need to have patience. Talk about the stigma. Get out of the silos. Talk about addictions and the intergenerational trauma. It’s all connected.
There’s a lot of racism. I hate to say it but there is. Some doctors weren’t really on board with the program. They’d say: ‘It’s so sad people still get hep C when it’s totally preventable’. Doctors don’t always understand that life isn’t as simple for everyone…
An emphasis needs to occur on displacing old language and replacing it with new language that is healing… throughout the entire system and circles of care. We need new ways of talking about this. What if we change the language to liver health, clear blood/clear body and get rid of words like testing and elimination?
They should test for anything and everything in school; I got [hep C] when I was really little.
The Roadmap Co-chairs
Dr. Alexandra King and Carrielynn Lund, the Community Guiding Circle and the project team made a commitment to this work, with an intent to serve the people living with or who have lived with hep C.
Dr. Alexandra King, Project Co-chair (SK)
We are at a critical moment for hep C. We have a fantastic cure for this virus that can cause both liver disease and cancer. And yet, many who need this cure the most are not able to access it. Instead, they face many of the same barriers that prevent them from accessing health care. We can and must do health care differently, so it works for everyone. This roadmap is intended to help galvanize our response and to pull all the key stakeholders together so we can better serve those living with hep C.
Email: alexandra.king@usask.ca
Carrielynn Lund, Project Co-chair (AB)
A heartfelt thanks to the members of our advisory group who provided invaluable guidance during this whole process, and to the local organizations and service providers who provided space, helped to coordinate the circles and invited people to participate. I would like to acknowledge the work of the TB Consulting team and members of our Pewaseskwan team who did an outstanding job of planning, implementing, interviewing and pulling everything together into this report. Lastly but most definitely not the least, I would like to thank my co-chair Alexandra King, who generously shared her wisdom, experience, passion and commitment for this important work.
Email: carrielynn.lund@usask.ca
Lead Organization
Waniska Centre: Saydi Harlton, Project Lead
Email: saydi.harlton@usask.ca
Consultation Support
Taylor Bassingwaithe
Bonnie Leask
Emmanuelle (Em) Morin
Community Guiding Circle Members and Contributors
Tai Ametepee
Emily Bear
Kate Dunn
Cari Egan
Lorraine Fradette
Jordan Goota
Shohan Illsley
Kelly Kaita
Ibrahim Khan
Dinesh Khadka
Sam Lee
Albert McLeod
Melissa Morris
Gayle Pruden
Rosemarie Ramsingh
Laurie Ringaert
Jenn Sharp
Eva Sinclair
Nidhi Singh
Mark Swain
Gene Tiefenbach
Renate Ziebert
Participating Organizations
Alberta Health Services
CanHepC Network
Federation of Sovereign Indigenous Nations
HIV Edmonton
Indigenous Services Canada
Ka Ni Kanichihk
Manitoba Harm Reduction Network
Manitoba HIV-STBBI Collective Impact Network
Northern Inter-Tribal Health Authority
Pewaseskwan (the Indigenous Wellness Research Group)
University of Calgary
University of Manitoba
University of Saskatchewan