A Way Forward for Hepatitis C Treatment Access in Asia
MSF's Leena Menghaney presents during the regional consultation on hepatitis C treatment access.
This July, TREAT Asia organized a second annual regional consultation to improve access to hepatitis C treatment in Asia. Available hepatitis C treatments are costly and complicated, and access remains very limited throughout the region. The event, A Way Forward on Hepatitis C Treatment Access and Advocacy Activities,brought together 20 advocates working on issues related to hepatitis C, HIV, and drug use from India, Indonesia, Nepal, Thailand, and Vietnam, and representatives from the Médecins Sans Frontières (MSF) Access Campaign, UNAIDS, and other regional organizations.
During the meeting, the group developed a joint work plan for the coming year. Their priorities include continuing and strengthening advocacy campaigns to reduce the price of the injectable drug pegylated interferon (which is part of the hepatitis C treatment regimen most commonly available in the region) and of new oral treatments that have higher cure rates and fewer side effects.
A treatment course of these new drugs, sofosbuvir (Sovaldi™)1 and simeprevir (Olysio™), costs much more than the already high-priced treatment course that includes pegylated interferon, and they are not expected to be available to patients in low- and middle-income countries in the near future. “While we are fighting for access to these newer drugs, we also have to continue to fight to reduce the price of pegylated interferon, as many people need treatment now and cannot wait for the new direct acting antivirals,” says Paul Cawthorne, former MSF Access Campaign Asia manager and moderator of the consultation.
In April, the World Health Organization (WHO) released its first hepatitis C management guidelines. They were designed to guide low- and middle-income countries’ hepatitis C treatment programs, but few in the region have adopted the guidelines or taken steps to implement treatment programs. The consultation participants also plan to advocate for regional WHO offices to work more closely with governments and civil society to assist them in adopting those aspects of the guidelines that are most feasible in their respective countries.
Additionally, the group plans to focus on improving treatment education and hepatitis awareness among people who inject drugs (PWID) and people living with HIV (PLHIV). According to global surveillance data, approximately 75–99% of PWID who are HIV-positive are also co-infected with hepatitis C, and 5–15% of all PLHIV are co-infected. Since the beginning of 2013, TREAT Asia has organized or sponsored 21 hepatitis C treatment-related trainings for medical doctors, other health professionals, and community members and organizations in the region, and has designed and released a series of easy-to-understand educational materials—available in Bahasa Indonesia, Chinese, English, Malay, Thai, and Vietnamese.
The advocates plan to expand these and similar educational programs and increase the involvement of community members and organizations in regional efforts to improve hepatitis C treatment access. “Though there have been considerable developments in the response to hepatitis C, real changes in the field have not yet happened and will take more time,” says Giten Khwairakpam, TREAT Asia community and policy project manager. “These engagements with the community are critical because they make our programs more meaningful at the grassroots level while we wait for changes in government policy and the cost of treatment.”
1The current cost for a course of this treatment in the U.S. is estimated at $84,000 for 12 weeks of therapy.