Could we eliminate hepatitis C in Australia?

19 Mar 2024

According to research officer and first-time lead author Naomi Beard, we already have the tools to eliminate the virus. The key is finding better ways to reach vulnerable groups.
That’s where her research comes in.

Naomi Beard

When Naomi Beard enrolled in a Master of Science (Epidemiology) in 2019, it felt like a gamble, “stepping into a career of the unknown”. But she hasn’t looked back.

“It was the best decision I could have possibly made,” she says.

Now, with her first paper as lead author just published in Emergency Medicine Australasia, the Margaret Hamilton Award recipient can’t imagine doing anything else.

“Epidemiology is a field where science can explain a disease, a biological risk factor, a transmission route of infection,” she says. “But the arts and humanities allow us to understand the social, cultural and behavioural elements of what it means to be human.”

This awareness of human experiences is as important to improving people’s lives as the hard evidence of science, she explains.

It is also at the heart of the research that was published this month.

By examining ambulance data and applying a socio-cultural lens to what they were seeing, Ms Beard and the team of researchers identified a unique opportunity to reach people often missed in testing and treatment for blood-borne viruses, including hepatitis C.

Reaching a group often missed in healthcare

According to Ms Beard, we already have the tools to prevent, manage and treat blood-borne viruses thanks to scientific interventions like vaccines and therapeutics. In the case of hepatitis C, we could even eliminate the disease from the Australian population.

“It's public health systems and the nuanced understanding of political, behavioural, cultural and social elements of particular groups we aren't quite getting yet,” she says.

Fear of stigma and discrimination are both examples of cultural mechanisms that make it difficult for people with complex health needs to access testing and treatment.

Other systemic issues that can lead to people missing out on care include language barriers, finite resources and gaps in community care.

In addition, people who are experiencing complex medical and social issues such as substance use disorder, mental illness, and domestic violence, or who live in a rural location, are less likely to access a general practitioner or community health service. As a result, they are often missed in other healthcare surveillance systems.

Unlike clinic-based health services, however, ambulances attend the patient’s location.

“This removes some of the physical and social barriers to access,” Ms Beard explains.

It is also an example of the intersection between the scientific data of ambulance call-outs and the socio-cultural understanding of the experiences of vulnerable groups that is at the heart of Ms Beard’s passion for epidemiology

Ambulance data through a cultural lens

By drawing on data from the National Ambulance Surveillance System (NASS), the researchers from Monash University, Turning Point and Ambulance Victoria examined ambulance call-outs from people with a history of a blood-borne virus, who are often missed in healthcare surveillance. 

Examples of the viruses captured in the research include human immunodeficiency virus (HIV), hepatitis C and hepatitis B.

The researchers found that patients with any blood-borne virus history had an ambulance attend them on average over 2 and a half times each year. The average time spent with patients was an hour and 12 minutes.

“This suggests that these people with a blood-borne virus history frequently engage with ambulance services,” Ms Beard explains.

As part of their recommendations, the researchers found that paramedics could provide referrals that ultimately connect this vulnerable group to the care that they need, creating a link that has been missing.

A team effort

According to Ms Beard, the only way to improve access to care for groups that are currently being missed is by ensuring that our health systems are safe and accessible for everyone.

“Identifying and helping these vulnerable groups is essential,” she says. “Public health is a team effort, and sometimes we need to focus our resources a little more on some groups to help get them the care they need for the benefit of the population.”

This focus of resources on specific groups to help them access care for the benefit of all is perfectly illustrated in the team’s research just published

By implementing their recommendations, we could better manage and prevent HIV and hepatitis B while moving one step closer to eliminating hepatitis C from the Australian population. 

Looking back on the time since starting her degree, Ms Beard is grateful to everyone at Turning Point who has helped her grow as a researcher and reach her first publication as first author.

Being able to come into work every day and know I am going to learn something new about a different group of people, about a health condition, about systemic social and structural issues is incredibly fulfilling,” she says.

“Above all, I hope that my work improves the lives of the people that are the focus of my research.”

Read the paper: Using ambulance surveillance data to characterise blood-borne viral infection histories among patients presenting with acute alcohol and other drug-related harms

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Funding for the database is provided by the Department of Health (Victoria).