Hepatitis C is an insidious and highly stigmatized disease that affects an estimated 58 million people worldwide. Many people aren’t even aware they have it until they experience the symptoms of liver damage or develop cancer. To combat hepatitis C, three physician-scientists from top hospitals in Montreal have created a new initiative, Montréal sans HépC, to make ours the first city in North America to eliminate the virus.

It’s easy to assume that hepatitis C is not a problem in Canada, but the reality is that over 200,000 people across the country are living with the virus right now. The most shocking part of this statistic is that hepatitis C is curable. Despite this fact, it is responsible for more years of life lost in Canada than any other infectious disease, including HIV. This is because the virus affects underserved people, many of whom go untreated because they face significant barriers to accessing health care.

“I believe strongly in tailored and quality health care access for all. With Montréal sans HépC, we can reduce barriers to care for some of Montreal’s most underserved inhabitants. Hepatitis C is curable—and curing Hepatitis C contributes to reducing transmission, a key element to HCV elimination,” says Dr. Julie Bruneau, Clinical scientist, Addiction Medicine, CHUM; and Canada Research Chair in Addiction Medicine.

Montréal sans HépC’s ambition is in its name: this initiative will halt hepatitis C transmission in the city by working closely with affected communities in the affected communities. The initiative is led by MUHC infectious disease expert Dr. Marina Klein, Dr. Julie Bruneau, drug addiction physician at the CHUM, and Dr. Christina Greenaway, leader in the Division of Infectious Diseases at the Jewish General Hospital.

To meet underserved individuals in their own communities, Montréal sans HépC has partnered with 16 community organizations. Their goal is to create grassroots interventions tailored to five groups at risk of hepatitis C: Indigenous peoples, immigrants, prisoners, men who have sex with men and people who inject drugs.

“Our program is about reaching out to communities that have been infected with hepatitis C and finding people who may not be aware of their infection. From there, we will increase testing, diagnosis and linkage to care,” says Dr. Klein, Research Director, Division of Infectious Diseases and Chronic Viral Illness Service at the MUHC.

One of the initiative’s closest partners is the Centre associatif polyvalent d’aide hépatite C (CAPHAC). Founded in 2003, CAPHAC offers support and information services for people working with communities impacted by hepatitis C, as well as for people living with the virus and their loved ones. By working together, Montréal sans HépC and CAPHAC can ensure individuals with untreated hepatitis C receive care without judgment.

“Our organization has been working to curb hepatitis C for 20 years. Montréal sans Hép C will bring us into the final stretch toward elimination of the disease,” says Laurence Mersilian, Executive Director of CAPHAC.

“Our desire to cure this infection isn’t just about restoring health to the body. It’s about restoring dignity by helping to end stigma,” says Dr. Klein.

Hepatitis C remains a problem in Canada because of the stigma surrounding it: it is associated with injection drug use. However, the disease is common in people of all walks of life. Baby boomers in particular may be unknowingly infected by the virus because of improper sterilization of dental and surgical tools prior to 1990. The tainted blood crisis in the 1980s, in which people across Canada were infected with the virus through blood transfusions, also led to many infections.

“Many people don’t even know that they have the virus, and it can take 20 to 40 years for complications to appear. This lack of diagnoses means many people go untreated until they become ill,” says Dr. Klein.

Astoundingly, treatment for hepatitis C is no more complicated than a daily treatment; taken for eight to twelve weeks, the antiviral medications are 95% effective. In spite of this simple solution, far too many people still live with the disease and experience its complications. The stigma surrounding hepatitis C is partially to blame, but the other piece of the puzzle is barriers to health care access: hepatitis C affects vulnerable people, many of whom have difficulty accessing the health care system due to lack of cultural safety, language barriers, the complexity of the health care system and many more. This is why Montréal sans HépC is so important: it brings health care to individuals on their terms and in spaces where they feel safe.

“Something that has really touched me is seeing how being cured dramatically improves the self-worth of my patients. It gives them a sense of accomplishment and that they now have something to live for. I think the model we are proposing represents a way to engage people more broadly in care, for many linked health and social conditions, in a positive way that will have lasting benefits,” says Dr. Klein.

Montréal sans HépC recently received a generous $1.35 million gift from Scotiabank through the McGill University Health Centre (MUHC) Foundation to support implementation of the program. Philanthropy has played a vital role in helping Drs. Klein, Bruneau and Greenaway lay the groundwork to reduce the burden of hepatitis C in Montreal. With the support of donors, they hope to create a model for hepatitis C prevention that can be replicated across the continent and even around the world.

“Montréal sans HépC will not only improve the health of Montrealers, it has the potential to change the lives of millions of people. This is the power of philanthropy. Every gift we receive toward this program is another step closer to ensuring no one loses their life to the complications of hepatitis C,” says Julie Quennville, President and CEO of the MUHC Foundation.

With the help of Scotiabank and the expertise of its founders, Montréal sans HépC is preparing to implement its program, which will change the lives of thousands of Montrealers.

“Our desire to cure this infection isn’t just about restoring health to the body. It’s about restoring dignity by helping to end stigma,” says Dr. Klein.

Montréal sans HépC is a priority of the MUHC Foundation’s Dream Big. Solve Humanity’s Deadliest Puzzles campaign, which is raising $60 million to support the McGill Interdisciplinary Initiative in Infection and Immunity’s (MI4) innovative research in infection and immunity.  To learn more about the campaign and donate in support MI4, visit https://muhcfoundation.com/works/solve-humanitys-deadliest-puzzles

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