[Ip-health] Yale Report: Millions of People with Hepatitis C Blocked from Obtaining Treatment in Low-and Middle-Income Countries

Justin Mendoza justin.mendoza at yale.edu
Thu Feb 26 07:17:19 PST 2015

Apologies for Cross-Posting:

See Below a report from the Global Health Justice Partnership at Yale,
about Lack of access to Direct Acting Antivirals:
Wishing the best,

Justin Mendoza
Yale | School of Public Health
MPH Candidate *2015* | Health Policy
E: justin.mendoza at yale.edu
C: 269-762-2073 | @justindmendoza <https://twitter.com/JustinDMendoza>
Linkedin Available Here <http://linkd.in/1o9jLDn>

*CONTACT: Debra Kroszner (debra.kroszner at yale.edu
<debra.kroszner at yale.edu>) 203.432.1053 <203.432.1053>*

*For Immediate Release: February 26, 2015*

*Yale Report: Millions of People with Hepatitis C Blocked from Obtaining
Treatment in Low-and Middle-Income Countries*

*New Haven, Conn.*—Just last week, worldwide leaders came together in
Geneva, Switzerland at the World Health Organization to begin to develop a
five-year strategy to combat Hepatitis C. The disease, which affects 185
million people worldwide – five times as many people as HIV, predominantly
in low-and middle-income countries – has been called a silent epidemic.
Now, a new report by Yale’s Global Health Partnership (GHJP)
the Treatment Action Group (TAG)
and the Initiative for Medicines, Access and Knowledge (I-MAK)
warns that global efforts to extend treatment to millions is in peril
unless key obstacles to access are confronted immediately.

The report, “*Ending an Epidemic: Overcoming Barriers to an HCV-Free Future
offers a comprehensive strategy for improving access to a new class of
medicines for the disease, the directly acting antivirals (DAAs), in
low-and middle-income countries and addressing these barriers.

“The new treatments for HCV are a game-changer: they are remarkably
effective and have few side effects,” said Christine Monahan ’16, a student
at the Yale Law School who co-authored the report. “Unfortunately, they are
prohibitively expensive for the vast majority of people who need treatment.”

The strategies used with other diseases, particularly HIV/AIDS, to extend
treatments to millions who need it has largely depended on getting less
expensive, generic versions of these drugs on the market, by pressuring
companies to allow other manufacturers to produce their drugs.

“Millions of patients in need of HCV treatments are in middle-income
countries. As we have also seen with AIDS, while big drug companies may
allow generic access for low-income countries, they are not willing to
relinquish control of these more lucrative markets so easily,” said Tahir
Amin, Director of Intellectual Property at I-MAK.

Sovaldi, one of the first new DAAs on the market, costs $1000 a pill or
$84,000 for a full course of treatment in the USA. Though its maker, Gilead
Sciences Inc., has discounted the price for low- and middle-income
countries in some cases, the price is still too high in countries like
India where treatment costs about 20% of the average annual income. Yet
generic companies could produce the drug for a few hundred dollars for a
full course of treatment.

“We are going to need far more aggressive policies and political
solutions—including patent oppositions and compulsory licenses—to secure
generic access to these drugs around the world,” said Kyle Ragins ’15, a
student at Yale’s medical and management schools and a co-author of the
report. “Gilead, AbbVie and others aren’t going to offer these medicines at
the prices millions need if they are to get access to them.”

The report also details the other barriers to providing HCV treatment to
those who need it. “Even with lower prices, countries can’t cover HCV
treatment on their own,” said TAG’s International Hepatitis/HIV Policy and
Advocacy Director Karyn Kaplan. ”Just as with HIV/AIDS we’re going to need
international donors to step up like they did with the Global Fund to Fight
AIDS, TB and Malaria, to make HCV treatment a reality for millions around
the world.”

“We also need to make it easier to provide treatment around the world by
relying less on liver and HCV specialists to provide care and turning
towards nurses and community health workers to do so,” added Tracy Swan,
TAG’s Hepatitis/HIV Project Director.

The report also details the specific needs of key populations at high risk
or with high prevalence of HCV, such as people who inject drugs. “We need a
comprehensive approach to treatment of HCV for these individuals, that is
integrated with the services they also require to live healthy lives,
including needle and syringe exchange programs and opiate replacement
therapy” said Sara Heydari, a 2014 graduate of the Yale School of Public
Health, who is a co-author of the report.

The new treatments for HCV—unlike those for HIV—provide a complete cure for
HCV.  This means that eradication of the disease is possible.  However, the
barriers to access to HCV treatments require major changes in the political

“The changes we need to see and that are articulated in the report require
activism, civil society needs to pressure governments, corporations, and
international organizations to take the actions necessary to make HCV
treatment accessible for all,” said Allana Kembabazi ’15, a Yale Law School
student who co-authored the report.

Retired American schoolteacher Pam Anderson, who recently finished her
course of HCV treatment and whose story is featured in the report, summed
up what’s at stake in the fight for access to HCV treatment: “I was
fortunate to have the combination of an excellent doctor, insurance and
support from a non-profit organization. Without these kinds of safety nets,
treatment—and hope—are not available to many HCV patients. Now, six months
post treatment I am still undetectable. Thanks to this new drug my whole
life and psyche have changed—my health is no longer deteriorating, I am not
constantly waiting for the other shoe to fall and I am no longer afraid to
make long-range plans. It is possible to eradicate this epidemic with
adequate funding and accessibility. Hopefully, it will soon become a
reality that all HCV patients will have the opportunity to be treated.”

Gregg Gonsalves
Global Health Justice Partnership
Yale Law School-Yale School of Public Health
P.O. Box 208215
New Haven, CT 06520-8215
Email: gregg.gonsalves at yale.edu
Skype: gregggonsalves

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