Magistrate Judge Joe L. Webster issued a 33-page opinion to U.S. District Judge William Osteen recommending that the court grant a preliminary injunction blocking the state’s current policy, which denies medically necessary, lifesaving treatment to many incarcerated people who suffer from the deadly disease.

North Carolina Prisoner Legal Services and the ACLU of North Carolina filed a federal class-action lawsuit in June on behalf of three people who are incarcerated, arguing that the state’s denial of medical service violates the Americans with Disabilities Act and the U.S. Constitution’s ban on cruel and unusual punishment.

“By providing universal testing and treatment for the deadliest infectious disease in the country, North Carolina prisons will not only meet the current standards of medical care — they will also help combat a major public health crisis,” said Dan Siegel, staff attorney for North Carolina Prisoner Legal Services. “The vast majority of people who are incarcerated will one day reenter the community, and medical experts have made it clear that the best way to combat the Hepatitis C epidemic is to screen and provide treatment to as many people — both inside and outside prison walls — as quickly as possible.”

“We are glad that the magistrate judge recognized the extreme and cruel harm North Carolina’s policy is causing to tens of thousands of people who are all at high risk of contracting this disease because they are in state prisons, as well as the broader community,” said Emily Seawell, staff attorney for the ACLU of North Carolina. “We hope the district court affirms this recommendation so that officials will begin screening everyone incarcerated by the state and provide this lifesaving treatment without delay.”

Hepatitis C is the most deadly infectious disease in the U.S., killing more Americans than the next 60 infectious diseases combined. North Carolina does not provide universal testing for Hepatitis C for all people incarcerated, even though the American Association for the Study of Liver Disease and the Infectious Diseases Society of America recommend doing so. The Centers for Disease Control and Prevention estimate that as many as one third of all people incarcerated in the U.S. suffer from the contagious disease. If left untreated, Hepatitis C can lead to liver cancer, portal hypertension, painful symptoms and death.