Nearly four million people in the United States have the hepatitis C viral infection with up to ten thousand dying annually across the nation. In response to this epidemic, a team of researchers has proposed combating the prevalence of the virus by treating those in the prison system; one in six prisoners are infected with the disease.
The virus, which can cause cancer or liver failure, is prominent among inmates due to shared needles for intravenous drug use. “It should come as no surprise that that same population of injection drug users also comes into contact with the criminal justice system with higher frequency,” stated Dr. Scott Allen, associate dean of the UCR School of Medicine and one of the researchers behind the study.
Most people who contract the virus are usually exposed in their communities rather than the prison system. “It’s not that the prisons spread the infection — they don’t. It’s that the prisons provide an opportunity to diagnose and treat the infection,” Allen stated.
In federal prisons, more than 50 percent of prisoners are incarcerated for drug offenses. “In 1997, nearly one-quarter of all people living with HIV or AIDS, nearly one-third of people with Hepatitis C and more than one-third of those with tuberculosis in the U.S. had been released from a prison or jail at some point during the year,” reads a federal policy report.
In the New England Journal of Medicine (NEJM) article authored by Allen, Dr. Josiah Rich and Dr. Brie Williams, it is suggested that treatment and research on prisoners is an effective way to tackle the epidemic nationwide despite the prevalence of the disease within overpopulated prisons. As 95 percent of prisoners are eventually released, many of the illnesses can continue in the community if not properly treated.
While prisons are already legally required to treat prisoners with hepatitis C, the treatments, according to Allen, are older and less effective. He continued by stating that prison officials “will have to give consideration to these new drugs, as hepatitis C is a serious and potentially life-threatening condition.”
Allen also argued that “the courts (including the U.S. Supreme Court) have already held failure to provide reasonable access to healthcare for serious medical conditions violates the eighth amendment ban on cruel and unusual punishments (sic),” citing the Brown v. Plata case which asserted the eighth amendment rights of prisoners in California due to prison overcrowding.
Treatments, however, are relatively expensive with the price tag of $84,000 per prisoner. Allen explained that new treatments are expensive because drug prices for new treatments are high in the U.S. free market-based system. Manufacturers point out that curing someone of chronic hepatitis C prevents the high costs that can result from the final stages of liver disease, thus giving them a reason to charge higher prices for early treatment.
Despite the high prices, the doctor added that, “While I don’t defend these high prices per se (I do see them somewhat as an exploitation of a captive market), I do agree with the math — which is to say even with these high prices, treating people now will be cheaper than waiting to treat them when they get sick down the road.”
Some students believe, however, other steps may be effective in preventing the spread of the virus. Alicia Paleno, a second-year English major, stated that, “While I think it’s important to make healthcare accessible to those in need, it seems more effective to focus on the root of the problem rather than the aftermath,” arguing that better sanitation in prison and policies to focus on the prevention of the disease are more important than focusing resources on treating them.
However, other students believe that this presents a great opportunity to combat the epidemic. Michael Hallahan, a fourth-year English major, stated that, “If this is able to contribute to harm reduction, and improve the well-being of prisoners and the community, we should try it regardless of the costs. The well-being of a person’s life is more important than monetary costs.”
Allen also argues to consider the human cost in terms of suffering from chronic and often terminal illnesses by not treating the disease properly.