To paraphrase author John Green, “It is a disease. It doesn’t have a moral compass. It doesn’t strike certain kinds of people because of certain kinds of reasons. [It] follows the paths of injustice that we blazed for it.”
Green was talking about tuberculosis in an interview about his most recent book, Everything Is Tuberculosis. But I see the same truth in viral hepatitis.
Over the past three years, I’ve had the privilege to visit front-line providers and peer support workers in communities in Manitoba, Yukon, and, more recently, Northern Ontario to better understand how hepatitis C persists even though we have been able to cure it easily for over a decade.
There is no mystery to where this disease shows up. It travels through under-housed communities, across the gaps between federal and provincial responsibilities, through crowded, under-resourced jails, and along the lingering legacies of racism and colonization.
The same can be said for hepatitis B: another preventable, treatable liver disease that continues to disproportionately affect newcomers and others excluded by Canada’s current patchwork approach to screening.
For both hepatitis B and C, the stigma can be intense, layered with misinformation and structural discrimination.
Too often, people go years or even decades without knowing they are infected, or without the treatment and care that could prevent serious liver damage or cancer. Imagine receiving a diagnosis for curable disease at the same time as you are diagnosed with liver cancer because that disease went untreated. It happens all too often, largely because we don’t have consistent, evidence-based guidance for who should be screened and when. In 2025, that’s not just an unfortunate gap. It’s a policy failure.
Canada’s commitment to eliminate viral hepatitis by 2030 depends on our ability to identify people early, offer curative treatment for hepatitis C or lifelong monitoring for hepatitis B, and build systems that work for everyone, not just those who can easily navigate them.
A recent federal report outlining a new framework for preventive health guidelines offers a promising way forward. It emphasizes the need to close equity gaps, involve subject matter experts, and align screening decisions with public health goals. Screening for both hepatitis B and C checks every one of those boxes, and should be prioritized under the new framework.
Another line from the same interview with Green captured my attention: “We are part of one human story, and the story of human health is deeply interconnected.” We’ve built systems that make it harder for some people to stay healthy, not understanding that our health is interconnected and this impacts us all.
On July 28, World Hepatitis Day, my message is a simple one: if we want better outcomes (for both individuals and the broader community), we need to design better systems that make prevention, testing, treatment, and care truly accessible for everyone. Modernized, evidence-based screening guidelines won’t solve every barrier, but they are a great place to start.
Viral hepatitis may be following the path we blazed for it, but we can choose a new way forward.
Jennifer van Gennip is the executive director of Action Hepatitis Canada.
The Hill Times