Islamabad: The Drugs for Neglected Diseases initiative (DNDi), Médecins Sans Frontières (MSF), FIND, the global alliance for diagnostics, and the Treatment Action Group are joining forces to tackle a ‘silent’ public health injustice: the continuing disparities in access to diagnostics and treatment for the hepatitis C virus (HCV) in low- and middle-income countries (LMICs), home to 75% of those living with this viral illness.
In Pakistan, Hepatitis C virus (HCV) is a major public health burden. HCV infections usually are asymptomatic, often go undiagnosed and can develop into a severe chronic disease. To help address this, Médecins Sans Frontières (MSF) has developed a simplified model of care, providing diagnostic, treatment, health education and patient support services at a primary healthcare level under one roof. The project is run in Machar Colony in Karachi since 2015, targets the general population and high-risk groups, and conducts regular screening sessions to actively link patients who test positive for hepatitis to care. In 2020, the MSF project team screened 4,226 people for HCV, and 906 patients successfully completed their treatment.
The Hepatitis C PACT will work in Latin America, Asia, Africa, and Eastern Europe –collaborating with ‘champion countries’ that are already revolutionizing hepatitis care The Hepatitis C Partnership for Control and Treatment, or Hepatitis C PACT, will foster an enabling environment for testing and treatment for HCV in LMICs by rolling out all-oral cures, scaling up community-based testing to find the missing millions of undiagnosed people, and addressing domestic financial challenges that prevent the launch of national programmes. It will also tackle patent and access barriers that stand in the way of reaching World Health Organization (WHO) goals of controlling hepatitis C by 2030.
Through its cumulative expertise and independence, the new partnership will build collaborations with countries and community and civil society groups and develop evidence to support ambitious test-and-treat programmes while addressing HCV financing obstacles.
Our organizations already have a successful track record in supporting test-and-treat programmes in ‘champion countries’, such as Cambodia, Pakistan, and Malaysia. The Hepatitis C PACT will make best use of countries’ strategic capacity to increase access to HCV care globally.
The Hepatitis C PACT will address four key areas responsible for such a low rate of access to testing and treatment – concentrating on boosting access to both polymerase chain reaction (PCR) testing and newer-generation hepatitis C drugs called direct-acting antivirals (DAAs). DAA treatments can cure patients in two to six months but non-generic versions have come with an infamously high price tag.
The partnership will focus on:
Increasing awareness among decision-makers: There is insufficient knowledge about HCV control among policymakers and other leaders. The partnership will generate key evidence on hepatitis C diagnosis and linkage to care, including in sexual health and harm reduction settings, advocate for policy change, raise awareness that the disease can be controlled, and provide community education.
Developing financing mechanisms for viral hepatitis strategies: Currently there is insufficient domestic and global financing for HCV control. A new financing working group comprising representatives from over a dozen agencies will identify and design sustainable financing mechanisms for DAAs and diagnostics to support and catalyse global and domestic resources in priority countries.
Supporting simplified viral hepatitis diagnostics: There is a need for simplification of the diagnosis of the chronic hepatitis C infection. The development of simple and affordable of such diagnostic tools will be prioritized, enabling decentralization of mass testing strategies.
Supporting access to simple and affordable DAA treatments for HCV in high-burden LMICs:
Despite decreases, DAA prices are generally too high to support large scale-up of treatment. The partnership will improve access to DAAs approved by WHO using a successful public-private partnership approach recently deployed in Malaysia for the approval of ravidasvir, a new DAA.
The Hepatitis C PACT is being launched with financing from MSF’s Transformational Investment Capacity initiative, with the objective of increasing access to treatment for HCV patients in LMICs.
Anna Cilliers, MSF Head of mission in Pakistan said: It is estimated that in Pakistan 10-15 million persons are infected with Hepatitis C Virus (source: national Hep C Program). MSF have been working in collaboration with the provincial and national Hepatitis C initiatives in order to increase awareness about hepatitis C prevention and to increase access to testing and treatment. If Hepatitis C is not treated, it can progress to advanced liver disease, like liver failure and liver cancer. MSF encourages individuals to ask their health care providers to screen them for Hepatitis C.
Bryn Gay, HCV Project Director at Treatment Action Group said: “We have a unique opportunity to cure hepatitis C in our lifetimes, and often investments in HCV opens the door for expanded prevention and harm reduction services in resource-limited countries. We’re excited that the Hepatitis C PACT can build on our successful track record of strengthening treatment and diagnostics literacy, which ensures affected communities can meaningfully and equitably participate and inform national hepatitis responses.”
Graciela Diap, HCV Access Project Leader at DNDi said: “HCV care and treatment remains significantly underfunded globally and nationally. Our partnership aims to build the investment case and the political will that can successfully mobilize additional global and domestic resources for HCV programmes. Securing political will and domestic resources can set the foundations for ensuring sustainable financing for HCV. We will underpin this work with sound policies that improve access to DAAs and diagnostics.”
The Hepatitis C PACT welcomes additional collaborators to join the effort, particularly investors and development banks. If you are interested, please contact Greg S Garrett, Director of Business Development and HCV Financing Lead at DNDi. firstname.lastname@example.org
+92 345 344 779 1
Treatment Action Group (TAG) is an independent, activist, and community-based research and policy think tank committed to racial, gender, and LGBTQ+ equity; social justice; and liberation, fighting to end HIV, tuberculosis (TB), and hepatitis C virus (HCV). TAG catalyzes open collective action by affected communities, scientists, and policymakers to ensure that all people living with or impacted by HIV, TB, or HCV — especially communities of color and other marginalized communities experiencing inequities — receive life-saving prevention, diagnosis, treatment, care, and information.We are science-based activists working to expand and accelerate vital research and effective community engagement with research and policy institutions for an end to the HIV, TB, and HCV pandemics. For more information: www.treatmentactiongroup.org
Doctors without Borders/Médecins Sans Frontières (MSF) provides medical assistance to people affected by conflict, epidemics, disasters, or exclusion from healthcare. Founded in 1971, MSF is today a worldwide movement of nearly 65,000 people. Our teams are made up of tens of thousands of health professionals, logistic and administrative staff allowing us to intervene in more than 70 countries. For more information: www.msf.org
The Drugs for Neglected Diseases initiative (DNDi) is an international non-profit research and development (R&D) organization that discovers, develops, and delivers safe, effective, and affordable treatments for the most neglected patients, in particular for sleeping sickness, leishmaniasis, Chagas disease, filarial infections, mycetoma, paediatric HIV, hepatitis C, and COVID19. Since its inception in 2003, DNDi has delivered nine new treatments, including fexinidazole, the first all-oral drug for sleeping sickness. For more information: www.dndi.org
FIND, the global alliance for diagnostics, seeks to ensure equitable access to reliable diagnosis around the world. We connect countries and communities, funders, decision-makers, healthcare providers and developers to spur diagnostic innovation and make testing an integral part of sustainable, resilient health systems. We are working to save 1 million lives through accessible, quality diagnosis, and save US$1 billion in healthcare costs to patients and health systems. We are co-convener of the Access to COVID-19 Tools (ACT) Accelerator diagnostics pillar, and a WHO Collaborating Centre for Laboratory Strengthening and Diagnostic Technology Evaluation. For more information: www.finddx.org