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Addressing Risk and Inaccessibility of HCV Treatment for Women Who Use Drugs

On this World Hepatitis Day, Women4GlobalFund (W4GF), a global movement network of 327
advocates from 75 countries dedicated to promoting gender equality within the Global Fund
programs, highlights the critical challenges faced by women in all of their diversity, especially women who use drugs, in accessing affordable, safe, timely, effective and high-quality treatment for Hepatitis C (HCV). Women represent a vulnerable group disproportionately affected by and at greater risk of HCV due to compounded barriers, including high treatment costs and systemic inaccessibility. Of the 50 million people living with HCV globally in 2022, an estimated 36% people knew their diagnosis, and of those diagnosed with chronic HCV infection, around 20% (12.5 million) people had been treated with DAAs by the end of 2022.

The Global Fund has been a key player in supporting harm reduction programs and investments aimed at combating HCV, particularly as a co-infection of HIV. Through its comprehensive funding and strategic partnerships, the Global Fund has endorsed and facilitated the implementation of WHO’s ‘Comprehensive Package’ of harm reduction services, which includes critical actions and services for preventing and treating HCV among women who use drugs. The ‘war on drugs’ remains a paradigm worldwide, fueling stigma, state violence, and informal drug markets in a state of constant and dangerous flux. Globally, a higher proportion of women (35%) than men (19%) are in prison for drug-related offences. Harm Reduction International (HRI) reports many health services and harm reduction programs are not tailored to the specific needs of women who use drugs. This lack of gender-sensitive and transformative approaches leads to poor health outcomes and increased vulnerability. A significant proportion (ranging from at least 15% up to nearly half depending on country/region) of all people who use drugs in the world are women.

Accounting for the concealing effects of criminalisation, gender power imbalances and stigma, the number of women who inject drugs is likely to be an underestimate. This increased vulnerability is aproduct of a range of environmental, social and individual factors affecting women, which also affect.