Situational Report: Sexual and Reproductive Health Rights in Australia

Marie Stopes Australia, Updated 17 April 2020

Situational Report: Sexual and Reproductive Health Rights in Australia – A request for collaboration and action to maintain contraceptive and abortion care throughout the SARS-COV-2 / COVID-19 pandemic

Executive Summary

We are in a context of increased risk of unplanned pregnancy, reproductive coercion, sexually transmitted infections, lack of pregnancy options and a multitude of barriers to healthcare. Access to contraception and abortion throughout the pandemic will mitigate broader public health risks for years to come. 
.
At Marie Stopes Australia, during the pandemic we have had to:

 Cancel surgical abortion care lists- meaning women and pregnant people have had to continue with their pregnancies or are likely to seek a termination at a later gestation
 Reduce our national gestational limit for surgical abortion to 22 weeks
 Face increased costs in the provision of regional healthcare, having no other option than to charter private flights for clinical staff
 Continuously scramble for Personal Protective Equipment (PPE)
 Reduce in-clinic list capacity to enable physical distancing
 Reduce contraceptive services in order to prioritise abortion access
 Reduce financial support for clients experiencing financial hardship
 Face increased risk of staff fatigue and burn out
 Evolve models of care in an effort to maintain access to care. To address this situation, we need to review legislation and policy, evolve models of care, maintain people’s rights to access care and make healthcare more affordable.

Key recommendations at this point in the pandemic include:
 All Governments, health and hospital services, and health clinics must consider abortion an essential service with Category 1 classification
 Provide access to medical abortion via telehealth for people living in South Australia
 Increase medical abortion provision to 70 days/10 weeks gestation, supported by the  Pharmaceutical Benefits Scheme (PBS)
 All accredited sexual and reproductive healthcare providers should have access to the National Medical Stockpile for PPE
 Intrastate travel support is needed for clinical staff in order to maintain surgical abortion provision in regional and remote clinics
 Do not criminalise women and pregnant people who attempt unsafe abortion

[This report contains] further detail on these points and a longer list of recommendations that Australia will need to consider in o order to maintain sexual and reproductive health
rights throughout the pandemic.

 

 

Nurse Practitioner (s100) Prescribing Change

Hepatitis Australia, 3 April 2020

Hepatitis Australia warmly welcomes recent changes to the Pharmaceutical Benefits Scheme (PBS) allowing authorised Nurse Practitioners to prescribe hepatitis B and hepatitis C medicines under the Highly Specialised Drugs (s100) Program.

Both hepatitis B and hepatitis C are under-treated and without improvement in a range of areas Australia risks falling short of agreed national and global viral hepatitis elimination goals. Expanded access to timely treatment and care is a critical component of the national response.

This important development acknowledges the clinical expertise of Nurse Practitioners and the therapeutic relationships they develop and maintain with highly stigmatised and often vulnerable populations.

Under previous arrangements, authorised Nurse Practitioners were able to prescribe treatments for hepatitis B and hepatitis C under the PBS General Schedule (s85). Where Nurse Practitioners were available in primary care services, this arrangement enhanced access to antiviral therapies in community settings.

From 1 April 2020, authorised Nurse Practitioners are also able to prescribe hepatitis B and hepatitis C treatments under the Highly Specialised Drugs (s100) Program. This matters because some people are not able to access primary care settings. The change therefore improves the availability of treatment for vulnerable populations such as people living in remote and regional areas, people experiencing homelessness, and people in custodial settings.

Hepatitis Australia congratulates the Pharmaceutical Benefits Advisory Committee for recommending this important change, and we thank our colleagues at ASHM (Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine) for their leadership in this matter.

Community members in need of more information about hepatitis B and hepatitis C may wish to contact 1800 437 222 (1800 HEP ABC). This National Hepatitis Infoline directs callers to the community-based hepatitis organisation in the relevant state or territory.

ASHM’s “Find a Prescriber” function helps community members find a Doctor or Nurse Practitioner who has attended ASHM’s hepatitis training. People can also speak to their GP about treatment.

https://ashm.org.au/news/pbac-endorse-np-prescribing-for-hepatitis-b-hepatitis-c-and-hiv-medicines/

and

http://www.pbs.gov.au/info/news/2020/04/authorised-nurse-practitioners-now-eligible-to-prescribe

—————————————————————————————————————

The above information was found here 

Information about TRUVADA and ATRIPLA delisting

Australian Federation of AIDS Organisations (AFAO), March 30th 2020

From 1 April 2020 Truvada for HIV treatment and for pre-exposure prophylaxis (PrEP) will no longer be available through the Pharmaceutical Benefits Scheme (PBS).

There are alternatives to Truvada for PrEP in Australia.

Community members eligible for PrEP can access generic versions of Truvada supplied by Apotex, Mylan and Lupin Generic Health. The drugs manufactured by these three suppliers contain the same active ingredients as Truvada.

In addition, from October 2020 Atripla will be delisted. A generic equivalent of Atripla has been approved by the PBS for community members who wish to continue using Atripla.

We encourage you to talk to your prescribing doctor if you want more information about these changes.

For more information, visit the following websites:

Medicare ineligible PLHIV in Australia

NAPWHA, May 2019

This NAPWHA report is an analysis drawing together several years’ worth of data from the main pharmaceutical industry suppliers of compassionate access antiretroviral (ARV) therapy in Australia and combines this with, for the first time, data from the State and Territory jurisdictions to produce the most accurate estimate to-date of the number of Medicare ineligible PLHIV in Australia. It comes with recommendations for systemic improvements.

HIV diagnoses in Australia drop to lowest number in 18 years: report

Kirby Institute, July 3rd, 2019

Australia continues to lead the world in HIV prevention and in 2018 recorded the lowest number of HIV diagnoses since 2001.

According to a report released today by the Kirby Institute at UNSW Sydney, last year there were 835 HIV diagnoses across the country, which represents a decline of 23% over five years.

The declines reported today are largely due to reductions in the number of HIV diagnoses that are reported as attributable to sex between men. Over the past five years, HIV diagnoses have reduced by 30% among this population.

The report reveals no declines among heterosexual populations, with new diagnoses relatively stable among this group.

Similarly, there have been no declines in HIV diagnoses among Aboriginal and Torres Strait Islander populations.

Australia will never be HIV-free if access to prevention requires a medicare card

The Conversation, January 23, 2019 12.21pm AEDT

by Nicholas Medland, Sexual health physician and senior researcher, UNSW

Australia aims to “virtually eliminate” HIV transmission by 2022, according to the health minister’s new national HIV strategy. This ambitious goal has been made possible by biomedical HIV prevention, a new and highly effective way of preventing HIV using medications.

But new inequalities are emerging between those who can and can’t access these medications because of their Medicare eligibility. These inequalities may undermine the success of HIV elimination in Australia and threaten Australia’s international reputation as a safe place to study, work and live.

Read more of Australia will never be HIV-free if access to prevention requires a medicare card