Hepatitis C has long been a public health problem in Australia. 'Revolutionary' new drugs with the potential to cure hepatitis C have now emerged. The Australian government has invested heavily in them, and has an ambitious goal to eliminate hepatitis C by 2030. Numerous shifts in policy and practice are required if the elimination agenda is to be realised. This paper explores the significance of these shifts. We ask: what is the race to elimination doing with the subject? We argue that the race to elimination can be understood, simultaneously, as: a product of posthuman forces, capable of being analysed using the theoretical tools made available via the posthuman turn; producing an intervention in what it means to be human; and generating a dilemma for people who use (or used) drugs, people with hepatitis C, and posthuman scholarship. In drawing out these issues, we aim to: trace the significant developments underway in hepatitis C medicine and raise awareness of them; encourage reflection on the consequences of these developments; and invite reflections on what might be lost when the human is remade by hepatitis C medicine.
New drugs with the potential to cure hepatitis C have emerged. There is great optimism within medicine about the transformative potential of cure, but this overlooks the entrenched discrimination and stigma associated with both hepatitis C and injecting drug use and the role of law in re/producing it. Drawing on interviews with key stakeholders such as policymakers, lawyers, and representatives from peer organisations (N = 30), Latour’s (2013) work on legal veridiction, Fraser and Seear’s (2011) conceptualisation of hepatitis C as a ‘gathering’, and Mol’s (2021) work on being, this paper explores the possibility that legal processes complicate the linear trajectory of progress and transformation cure promises. Our participants’ identify various legal processes that allow hepatitis C to echo or linger in people’s lives after treatment. These processes are remaking hepatitis C, and making perpetual hepatitis C subjects. We argue that we must grapple with these forces in the era of cure.
Increasing testing for viral hepatitis and HIV is central to meeting World Health Organization and Australian targets to eliminate blood-borne viruses as public health priorities by 2030. In this paper we draw on findings and recommendations from a Victorian consultation with 40 health and community practitioners engaged with blood-borne virus testing. The consultation focused on identifying what constitutes best practice in pre- and post-testing discussion in the current era of highly effective treatments for HIV and hepatitis C. Overall, the consultation found that the pre- and post-test discussion remains an important feature of testing, but, given that stigma continues to impact the lives of people affected by these viruses, sensitivity to this issue needs to inform how these discussions take place. We describe how primary healthcare settings can support the goal of upscaling HIV and hepatitis C testing in a way that delivers safe and stigma-free testing encounters. We offer the notion of ‘stigma-sensitive practice’ as a term to describe this approach to pre- and post-test discussions.
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