Ukraine: Generic drugs increase access to hepatitis C treatment

Out of Darkness- fighting Hepatitis C

UKRAINE 2018 © Aleksandr Glyadyelov

Hepatitis C, a major cause of chronic liver disease globally, is a particularly pressing problem in Ukraine. Around 3.6 percent of Ukrainians live with the viral disease, well above the estimated European average of 1.5 percent. The Mykolaiv region, in southern Ukraine, is one of the country’s worst-affected areas, and also suffers from high rates of HIV and HIV-hepatitis C coinfection.

Three years ago, Doctors Without Borders/Médecins Sans Frontières (MSF) began working with the Ministry of Health in Mykolaiv to use generic drugs to treat hepatitis C, the first time generics were used to treat the disease in Ukraine. MSF provided not only medications, but also tests, laboratory equipment, and supplies.

Before the project began, patients faced hepatitis C treatments that could last from 24 to 72 weeks, with only a 50 percent chance of success. This all changed when MSF began providing a new hepatitis C treatment using the World Health Organization-recommended combination of the drugs daclatasvir and sofosbuvir. Taken together, these two medications are effective in treating all types of hepatitis C infection. The treatment takes between 12 and 24 weeks, has fewer side-effects than other regimens, and reached a cure rate of almost 94 percent in Mykolaiv.

“Hepatitis C can be cured with highly effective treatment, but access to diagnostics and treatment remains limited, especially for vulnerable communities,” said Dr. Nazgul Samieva, MSF medical coordinator in Ukraine.

MSF provided drugs for more than 1,300 patients, 1,150 of whom have now completed treatment. Among our patients were people living with HIV or undergoing opioid substitution therapy. To help them cope emotionally, MSF also provided psychosocial support throughout their treatment. Over 7,200 health education and counseling sessions were conducted by former patients hired and trained by MSF.

“My objective is to find a drive within the patient; a desire and motivation to undergo the treatment,” said Andriy, an MSF peer educator. “My point of view is very important for doctors because I’ve had many problems in my life, including alcohol, drugs, and HIV. So I have these points of contact with the patients, they trust me, and they open up to me,” he explained.

With recent COVID-19 preventive measures limiting movements, our teams have been delivering medicines by mail and offering support by phone to guarantee continuity of care for hepatitis C patients and to ensure that they have information about how to avoid COVID-19 infection.

This month, having successfully achieved its goals, MSF will hand over management of the project to local health authorities.

MSF began working in Ukraine in 1999. Today our work in the country is focused on infectious diseases such as multi-drug-resistant tuberculosis and COVID-19.