11481 (2024). Hon Dr Ayesha Verrall to the Associate Minister of Health

11481 (2024). Hon Dr Ayesha Verrall to the Associate Minister of Health: What progress, if any, has been made in the quarter October – December 2023 in the priority area ‘Establish central stewardship for STBBI (including partnership approaches between relevant entities such as Te Aka Whai Ora and Manatū Hauora) with shared accountability to achieve strategic goals’ under ‘STRATEGIC DIRECTION 4: Leading for an integrated, supported, consumer-focused system’ as part of the Aotearoa New Zealand Sexually Transmitted and Blood Borne Infection Strategy 2023-2030?

Hon Casey Costello: Published in March 2023, the Sexually Transmitted and Blood Borne Infections (STBBI) Strategy sets out a roadmap to 2030 to achieve elimination of transmission and realise an Aotearoa New Zealand where STBBI are prevented and where all people living with STBBI live long and healthy lives free from stigma and discrimination.   I am advised that officials from across the Ministry of Health and Health New Zealand have developed a cross-agency STBBI work programme to implement the STBBI Strategy with an initial focus on the HIV, hepatitis C and syphilis action plans that sit under it, as well as hepatitis B. Officials have also developed contracts, or engaged with, other STBBI related non-governmental and community organisations such as the Needle Exchange Programme (NEP) and the New Zealand Sex Workers’ Collective as key stakeholders of the STBBI work programme. I am further advised that officials have had frequent communication and consultation with Hauora Māori providers and experts. The goals and objectives in the strategy are intentionally high-level and officials expect activities to deliver on the priority action plans noted above to contribute to these over time, including through: • Hepatitis C modelling to refine the prevalence estimate of Hepatitis C in New Zealand to better understand the burden of disease and where resources should be directed. • An audit of HIV and syphilis antenatal screening to inform further work with maternity/midwifery. This will contribute to steps towards eliminating congenital syphilis. • Developing a social marketing campaign to challenge stigma and discrimination experienced by people living with HIV.   I am further advised that a specific focus over the past year has been on progressing initiatives within the HIV Action Plan through funding allocated in Budget 2022. This has included: • Funding community HIV service providers, including a kaupapa Māori HIV service provider to:  o scale up peer and community-led programmes, and resources that focus on connecting and empowering people living with HIV  o deliver programmes that increase knowledge and access to combination prevention for communities that have migrated from high HIV prevalence countries  o scale up innovative HIV testing and provide workforce training to conduct testing.  • Publishing updated clinical guidance for combination prevention for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) prescribing in primary care.  • Commissioning behavioural surveillance research to monitor modifiable behaviours driving HIV transmission for men who have sex with men.   In addition the following initiatives have been progressed in respect to the Hepatitis C Action Plan: • Increasing access to hepatitis C testing and treatment through regionally-led services. This includes more nurse led clinics and peer-led point-of-care testing delivered in community settings including pharmacies, needle exchanges, correctional facilities and Māori health services as well as a range of outreach services using mobile Hep C vans and pop up clinics. • Delivering a successful national hepatitis C campaign in 2022 called ‘Stick it to Hep C’ to raise awareness of testing and treatment. • Reclassification of Maviret has been gazetted to allow appropriately trained nurses and pharmacists to provide hepatitis C treatment without a prescription. • Completing and promoting the national hepatitis C HealthPathway to primary care and Māori health providers. • Commencing the hepatitis C modelling project to refine the prevalence of hepatitis C in New Zealand. Priority actions from the National Syphilis Action Plan have also been progressed. This work includes developing a teaching package for midwives on syphilis and other sexually transmitted infections (STIs) and implementation of an enhanced surveillance system for STIs including syphilis. Work is also underway to recruit contact tracers across all 4 regions of New Zealand and to look at innovative testing approaches for STIs.   Specific activities, from October to December 2023, included: • The STBBI Technical Advisory Group (TAG) was established. The purpose of this TAG is to provide technical advice on data, surveillance, and monitoring to the STBBI cross-agency programme team, with an initial focus on components of the HIV Action Plan. Members of the TAG include technical experts within Health New Zealand and the Ministry of Health, and external technical experts from the STBBI sector. • Completing updated clinical guidance for combination prevention for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) prescribing in primary care.  • Development of Hepatitis C reclassification training for nurses and pharmacists was progressed in collaboration with the Nursing Council, Pharmacy Council and Pharmac. • The NEP upscaled the distribution of free injecting equipment to people who inject drugs. The STBBI Strategy is a seven year strategy that provides an opportunity to progress prioritised actions in a coordinated way. I am advised that work on some priorities across the seven year life of the strategy are yet to be progressed. Consequently, no work on some of the priorities was progressed between October – December 2023.