Canada needs safe-injection sites in every region to curb the spread of hepatitis B and C, says a health-care coalition that is calling for a more aggressive approach to combat the diseases.

The Canadian Coalition of Organizations Responding to Hepatitis B and C has issued a report card on Canada's performance and found that resources are inconsistent across the country.

Co-ordination appears particularly poor in Prince Edward Island, Nunavut and the Northwest Territories and prison inmates across the country are especially vulnerable, the group says in its report.

"Governments are essentially failing in terms of the prison population," the report says.

"There is no consistency from one institution to the next. Harm-reduction measures, resources and equipment must be available and accessible in all provincial and federal institutions."

The report notes that besides safe-injection sites, all regions also need methadone clinics and needle exchanges.

"All governments need to adopt a broader perspective on the determinants of health if they are to be able to address the harms associated with drug use and drug use policy," the report says.

It also suggested some prison policies actually hinder harm reduction.

Vancouver hosts North America's only safe-injection site, known as Insite, and the facility has been the subject of lengthy court wrangling after the Conservative government indicated its intention to have the facility closed. The case is currently before the Supreme Court of Canada.

Hepatitis B and C are infectious diseases of the liver. They can lead to serious liver damage, prompting the need for transplants, and can cause liver cancer.

While needle sharing has long been fingered as a vehicle for spreading hepatitis, as well as HIV, a study earlier this month from the University of Victoria concluded hepatitis may also be spread through shared crack pipes.

The report gave governments a grade of C- for ensuring every infant born in Canada is given a free vaccination against the diseases and the same grade was given to efforts to identify and offer vaccinations to those who didn't get it as an infant.

"It remains clear that too many people remain undiagnosed and untreated for (hepatitis C). Screening based on age, as well as risk, needs to be enforced," the report says.

Ultimately, the treatment for someone who has suffered the full effects of the diseases is a liver transplant, but the report says the numbers of transplants are too low.

The group recommends the federal government take a more active role in prompting organ donation.

The group also recommends the government add hepatitis B to the list of reportable diseases. Hepatitis C is currently on the list.

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