SAN FRANCISCO NEEDS A SUPERVISED INJECTION CLINIC

San Francisco is in the midst of a hepatitis C epidemic. More than
12,000 people here live with hepatitis C, many of whom do not know
they have it. The city has the highest rate of liver cancer in the
country because of hepatitis infections. Treatment for hepatitis C is
difficult, expensive and not always successful. People continue to
become infected with hepatitis C in San Francisco, primarily through
injecting drugs but increasingly through sexual contact as well.

For the past year and a half, I have been a member of the San
Francisco Mayor's Hepatitis C Task Force, along with 30 other
dedicated participants, including doctors, researchers, advocates and
people living with hepatitis C. We spent more than a year gathering
information, listening to research presentations and personal
testimony, reviewing state and national hepatitis plans, and
deliberating on what we could recommend to ensure that San Francisco
does a better job of addressing hepatitis C and preventing new infections.

One of our recommendations has attracted attention, including an
article in The Chronicle. As a part of our direction that San
Francisco must provide effective hepatitis C interventions, we
recommended the creation of a legal, supervised injection facility.

Supervised injection facilities are places where people can safely
use illicit drugs such as heroin with sterile equipment and medical
staff on hand. Supervised injection facilities are operating in 27
cities around the world, including in Vancouver, British Columbia;
Sydney; and Oslo. The evidence is conclusive that they reduce HIV and
hepatitis transmission risks, prevent overdose deaths, reduce public
injections, reduce discarded syringes and increase the number of
people who enter drug treatment. Few people would disagree with any
of those outcomes.

The mayor and other San Francisco politicians who are committed to
reducing the harms that drugs create for our communities would be
well served by paying attention to the evidence and lessons from
Vancouver. San Francisco has led the way in fighting HIV. The city
needs to take these recommendations seriously and begin to address
hepatitis C with the same courage and leadership it has shown for
HIV. Politics can't trump science.

Even here, we have some officials who remain invested in addressing
drugs as a criminal justice issue rather than a public health issue.
They continue to support the status quo, where people cycle through
our jails and emergency rooms at great cost. We will continue to
waste resources putting sick people in jail until our elected
officials and policymakers are willing to step up and redirect
resources to more effective approaches that will save money over
time, such as a supervised injection facility. There are too many
lives on the line, and there will be a price for a slow learning curve.

San Franciscans face a choice: Do we continue to waste money and
allow people to become sick and die, or do we follow the clear
evidence and invest in something that works?