A hepatitis C cure is here, but still too few people can get it
Opportunities to increase access to the hepatitis C cure exist – but strong political will is needed and many countries are failing to benefit from cheaper generics.
A cure for hepatitis C (HCV) is now available, but many countries are finding it difficult to get this lifesaving treatment to those who need it. This is despite an astonishing 60% of people who need HCV curative treatment living in countries where governments could procure more affordable generic cure drugs.
Just 3 million of the estimated 71 million people living with HCV worldwide were on curative treatment in 2016, called direct acting antivirals (DAAs). These drugs have transformed the HCV response in recent years, with simplified treatment courses and drug formulations that can cure up to 95% of cases in just 8 to 12 weeks.
But DAAs are expensive, and both low- and high-income countries are struggling to increase the number of people receiving this ground-breaking treatment.
Between 2015 and 2016, there was a 50% increase in new treatment starters. But according to a World Health Organization (WHO) progress report on HCV treatment scale up in lower and middle income countries (LMICs), half of those starting treatment in 2016 were in Egypt and Pakistan.
Other countries reporting progress included Australia, Brazil, China, France, Georgia, Mongolia, Morocco, Rwanda and Spain.
These countries have shown strong government commitment, which has allowed for the development of HCV treatment plans, for resources to be allocated to necessary services, and for drugs to be secured at more affordable prices. This includes producing or procuring generic drugs via voluntary licensing, or through price negotiations with the drug developer.
Egypt’s story is perhaps the most remarkable. With one of the largest HCV epidemics in the world, they are now on-track to eliminate HCV by 2030, an unthinkable prospect just a few years ago. This monumental turn-around is the result of improved government commitment in the form of a widespread testing campaign and the scale-up of the world’s largest HCV treatment programme. Here, patents for key HCV drug, sofosbuvir, were either not filed, or rejected, which allowed for several generic manufacturers to enter the market. This competition has led to a dramatic drop in the price of this drug.
Their progress shows that where there is political will and the ability to get drugs cheaply, epidemics can be brought under control.
Dr Gottfried Hirnschall, Director of the WHO Department of HIV and Global Hepatitis Programme, commented, “We appeal to global and national leaders to seize the incredible opportunities now available to cure all people of chronic hepatitis C and save lives. Champion countries are rapidly scaling up, showing that the elimination of hepatitis C is not a pipe dream – it can and has to be done.”
In 2016, the WHO led the ‘Global Health Sector Strategy on Viral Hepatitis, 2016 – 2021’, which aims to get 80% of all people infected with HCV onto curative treatment and to eliminate HCV by 2030.
The WHO is now calling for more action to help achieve these targets, and has devised a number of strategies to support this. These include adding generic versions of sofosbuvir to the WHO Prequalification Programme to increase medicine access; making patent-related barriers to treatment more transparent; and supporting countries to understand where opportunities for affordable treatment exist.
This story was developed by Avert and the World Health Organization (WHO) Department of HIV/AIDS and Global Hepatitis Programme.