Canada's pledge to eliminate hepatitis C by 2030 could be undermined by Nova Scotia's model of coverage for treatment, says an advocate for those with the virus.
Roughly 5,000 Nova Scotians are living with hepatitis C, a virus that infects the liver and can cause liver damage and cancer.
In May, a new treatment that researchers have hailed as a cure was added to Nova Scotia's pharmacare program.
But Alexandra MacDonnell, executive director of the Hepatitis Outreach Society of Nova Scotia, said not everyone infected with the virus is eligible for treatment under the program.
"There's a whole group of people that we're missing who are still able to transmit the virus, so it's hard to eliminate the virus when we're not treating everybody," MacDonnell told CBC's Information Morning.
'They're just not being cured'
In Nova Scotia, those with stage two fibrosis from hepatitis C — which means the infection has caused some liver damage, possibly resulting in flu-like symptoms — as well as more advanced stages of the virus, are eligible for coverage.
Patients in the earlier stages of the virus are not eligible except in certain circumstances, even though they can still transmit hepatitis C. Infection can be spread through tattoo needles, intravenous drug use, unprotected sex and other forms of blood-to-blood contact.
MacDonnell said the eligibility requirements may be motivated by cost but are counterproductive from the standpoint of public health.
"No other illness really waits until you're more sick [before offering treatment]," she said.
"You're missing a group of people when it comes to clearing the virus, so these people are still able to transmit the virus, but they're just not being cured right now."
The Department of Health and Wellness said in a statement that treatment for hepatitis C is expensive, and funding has been organized to give the sickest patients access to treatment first. The department said its intention is to provide open coverage to everyone with hepatitis C within a year.
Advancing a cure
MacDonnell said treatment for hepatitis C can cost between $60,000 and $110,000 for a 12-week course of medication.
Coverage is an important advancement in public health, she said.
"The [World Health Organization] states that by 2030 they want to eliminate hepatitis, so it's a great first step towards that," she said.