Preventing epidemics –by putting in place measures to protect people from infection – often takes place without fanfare and over many years.
An example is Tasmania’s Needle and Syringe Program which is part of one of the most successful public health measures implemented in Australia in the past few decades.
The NSP plays a major role in preventing the transmission of blood borne diseases like HIV, hepatitis C and hepatitis B in the Tasmanian community. Anglicare delivers this important service at outlets in Hobart, Glenorchy and Burnie where it makes safe equipment available to people who use injecting drugs.
“The first NSP was set up in Australia in 1986,” said Dr Faline Howes, Clinical Director of the Communicable Disease Prevention Unit at the Department of Health and Human Services. “Governments realised they needed a significant public health response to HIV and legislation was passed to enable the legal distribution of needles and syringes and other injecting equipment”.
Tasmania’s NSP started in 1993. “The Needle and Syringe Program is considered a major public health success story,” said Dr Howes. “The sharing of injecting equipment poses the greatest risk of exposure to blood borne viruses. There is well documented evidence that greater availability and use of injecting equipment reduces the incidence of these viruses”.
Dr Howes said NSPs had been endorsed internationally by the World Health Organisation, UNAIDS and the UN Office of Drugs and Crime. “That’s because of clear evidence about NSPs’ effectiveness, sustainability and the population health benefits,” she said.
“In countries where Needle and Syringe Programs have been implemented they have managed to avert HIV epidemics among people who inject drugs, while countries that haven’t implemented these measures have often experienced uncontrolled epidemics,” she said.
It is estimated that between 2000 and 2009, the existence of NSPs in Australia prevented 32,061 HIV infections and 96,918 hepatitis C infections, with savings of $1.28 billion in healthcare costs.
Anglicare’s NSP outlets supply clean equipment so people who inject drugs do not need to share or re-use syringes and needles. It’s also a safe place to dispose of used needles and syringes.
“The NSP outlets are an important health gateway,” said Dr Howes. “People who inject drugs may have a range of complex healthcare needs and often have trouble accessing healthcare. The NSP might be the only way they come into contact with health education, information and referral to other healthcare or treatment services,” she said.
“Since the introduction of NSPs, rates of sharing needles have certainly reduced in Tasmania and I think awareness about safe injecting practices is down to the fabulous workers in the NSPs,” said Dr Howes. “They do a lot more than provide equipment. They are that lovely, non-judgmental point of contact and over time build a really nice rapport with people. This has health and social benefits to the community. It is really valuable work”.
Dr Howe said NSPs were currently sharing information about the availability of new treatment for hepatitis C. “The potential to eliminate hepatitis C has become a real possibility for Australia and NSPs are playing a big part in raising awareness,” she said. “Our most recent data shows that in Tasmania we have treated one third of people living with hepatitis C - which is above the national average”.
Dr Howes said NSPs also continued to contribute to preventing the spread of HIV. Globally, there are 36.9 million people living with HIV. “We have made significant headway with HIV in terms of treatment but there is still no cure. Prevention is still the best strategy,” she said.