Echoes and Antibodies: Legal Veridiction and the Emergence of the Perpetual Hepatitis C Subject
| Author | Kate Seear,Suzanne Fraser,Sean Mulcahy,Dion Kagan,Emily Lenton,Adrian Farrugia,kylie valentine |
| DOI | http://doi.org/10.1177/09646639221115698 |
| Published date | 01 April 2023 |
| Date | 01 April 2023 |
| Subject Matter | Articles |
Echoes and Antibodies:
Legal Veridiction and the
Emergence of the Perpetual
Hepatitis C Subject
Kate Seear , Suzanne Fraser,
Sean Mulcahy , Dion Kagan,
Emily Lenton, Adrian Farrugia
Australian Research Centre in Sex, Health and
Society, La Trobe University, Australia
kylie valentine
Social Policy Research Centre, University of New
South Wales, Australia
Abstract
New drugs with the potential to cure hepatitis C have emerged. There is great optimism
within medicine about the transformative potential of cure, but this overlooks the
entrenched discrimination and stigma associated with both hepatitis C and injecting
drug use and the role of law in re/producing it. Drawing on interviews with key stake-
holders such as policymakers, lawyers, and representatives from peer organisations (N
=30), Latour’s (2013) work on legal veridiction, Fraser and Seear’s (2011) conceptualisa-
tion of hepatitis C as a ‘gathering’, and Mol’s(2021) work on being, this paper explores the
possibility that legal processes complicate the linear trajectory of progress and transform-
ation cure promises. Our participants’identify various legal processes that allow hepatitis
C to echo or linger in people’s lives after treatment. These processes are remaking hepa-
titis C, and making perpetual hepatitis C subjects. We argue that we must grapple with
these forces in the era of cure.
Corresponding author:
Kate Seear, Australian Research Centre in Sex, Health and Society, La Trobe University, Australia.
Email: k.seear@latrobe.edu.au
Article
Social & Legal Studies
2023, Vol. 32(2) 216–236
© The Author(s) 2022
Article reuse guidelines:
sagepub.com/journals-permissions
DOI: 10.1177/09646639221115698
journals.sagepub.com/home/sls
Keywords
Hepatitis c, stigma and discrimination, cure, law, veridiction, gathering, science and
technology studies, qualitative research
Introduction
The blood-borne virus hepatitis C is a longstanding global public health challenge.
Approximately 58 million people globally live with hepatitis C (World Health
Organization, 2021), including 188,951 in Australia (MacLachlan et al., 2021). In
Australia, transmission occurs principally in the context of injecting drug use, via the
sharing of needles and syringes or ancillary injecting equipment. If left untreated, hepa-
titis C may progress to liver disease or liver cancer. For many years, the most widely
available treatment for the disease was known as a ‘combination therapy’of interferon
and ribavirin. Combination therapy was a notoriously onerous regimen, taken across
24–48 weeks, and generating a wide range of serious side effects including severe
fatigue, nausea, vomiting, hair loss, muscle pain, flu-like symptoms, weight loss,
anaemia, diarrhoea, anxiety, depression, suicidal ideation, and reduced white blood
count (Harris and Rhodes, 2013; Hopwood and Treloar, 2005). Many people discontin-
ued treatment before the end of their treatment cycle, and the average cure rate over all
hepatitis C genotypes was just 40% (European Association for the Study of the Liver,
2020), although some genotypes had higher cure rates than others. However, new
drugs for the treatment of hepatitis C have emerged in recent years. Known as
‘direct-acting antivirals’or DAAs, these drugs are far more tolerable and effective than
previous treatments, with few side effects and cure rates of over 95% (European
Association for the Study of the Liver, 2020). Buoyed by these developments, the
World Health Organization announced an ambitious goal to eliminate hepatitis C globally
by 2030 (World Health Organization, 2016). The Australian government has invested
heavily in these drugs, adding them to the subsidised prescription medication program,
the Pharmaceutical Benefits Scheme, promising access for all, with no restrictions
according to disease stage, treatment history or drug use status (Australian Department
of Health, 2018). As Australia is one of the few countries in the world to have adopted
and taken steps to implement the WHO’s elimination goal, many countries are closely
watching its progress.
With the advent of DAAs, we are being invited to imagine a world without hepa-
titis C, where lives are radically transformed by cure. These new treatments are fre-
quently described as game-changing, ground-breaking, transformative,
revolutionary, and unprecedented (e.g. Scott et al., 2017: 107; Rice and Saeed,
2014: 43; Dore and Martinello, 2020: 238; Lin et al., 2017: 993). For example, the
national body for people living with hepatitis, Hepatitis Australia, released a state-
ment noting that:
The new direct-acting antiviral medicines listed on the Pharmaceutical Benefits
Scheme (PBS) from 1 March 2016 onwards, have revolutionised treatment of chronic hepa-
titis C by increasing the cure rate toclose to 100%, while reducingtreatment duration andside-
Seear et al. 217
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