World Hepatitis Day: MSF launches partnership to tackle hepatitis C

Hepatitis C active case finding

Cambodia 2019 © Simon Ming/MSF

Hepatitis C PACT aims to increase access to treatment and cure more people living with the virus in low- and middle-income countries

NEW YORK/PARIS/GENEVA, JULY 28, 2021—Doctors Without Borders/Médecins Sans Frontières (MSF)—in collaboration with the Drugs for Neglected Diseases initiative (DNDi), FIND, the global alliance for diagnostics, and the Treatment Action Group—launched a new partnership to address the continuing disparities in access to diagnostics and treatment for people living with hepatitis C (HCV) in low- and middle-income countries (LMICs), where more than 75 percent of people infected with the virus live.

The Hepatitis C Partnership for Control and Treatment—or Hepatitis C PACT—will work with countries and communities to roll out all-oral cures more widely, scale up community-based testing to find the missing millions of undiagnosed people, and address domestic financial challenges that prevent the launch of national programs in LMICs. It will also tackle patent and access barriers that stand in the way of reaching World Health Organization goals to better control hepatitis C by 2030.

“We have a unique opportunity to cure hepatitis C in our lifetimes," said Bryn Gay, HCV project director at Treatment Action Group. “Often investments in HCV open 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.”

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 programs while addressing HCV financing obstacles. Test-and-treat is an approach where a person is put on treatment immediately after testing positive for hepatitis C rather than being put on treatment during a follow-up appointment.

“HCV care and treatment remains significantly underfunded globally and nationally,” said Graciela Diap, HCV access project leader at DNDi. “Our partnership aims to build the case for investment and the political will that can successfully mobilize additional global and domestic resources for HCV programs. 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.”

MSF and the other organizations involved already have a successful track record in supporting test-and-treat programs in “champion countries,” such as Cambodia, India, and Malaysia. The Hepatitis C PACT will use these countries’ strategies—like offering care at the community level rather than only in facilities located in major cities—as an example and way to increase access to HCV care globally.

MSF has been working with Cambodia's Ministry of Health since 2016 to enable access to treatment, simplify hepatitis C care, and integrate this model in routine health services,” said Mickaël Le Paih, MSF head of mission in Cambodia. “The cure rate for thousands of patients remained over 97 percent for people treated in tertiary level clinics or primary health care centers. We have shown through our collaboration with the Cambodian Communicable Disease Control Department and through peer-reviewed reports that such a model of HCV care allows rapid scale-up while maintaining a high quality of care, mostly delivered by trained nurses. Communicable diseases such as HCV can be controlled through supporting state-run response programs.”

The Hepatitis C PACT will focus on increasing low rates of access to testing and treatment by increasing awareness among decision makers, developing sustainable financing mechanisms to combat the disease, supporting simplified viral hepatitis diagnostics, and supporting access to simple and affordable direct-acting antiviral (DAA) treatments for HCV in high-burden LMICs. The partnership will concentrate on boosting access to both better polymerase chain reaction (PCR) testing and DAAs, which are newer-generation hepatitis C drugs with high cure rates. In fact, DAA treatments can cure patients in two to six months, but non-generic versions often come with extremely high price tags.

“Boosting HCV testing to find the missing millions of people who don’t know they are infected and simplifying their path to treatment requires a multi-faceted approach,” said Sonjelle Shilton, hepatitis lead at FIND. “Drawing on the strengths of multiple partners including the Malaysian government and DNDi, we have already been able to demonstrate the benefits of making both diagnosis and treatment available in primary care clinics. Patients in Malaysia now have access to a one-stop-shop for HCV care at 200 primary care clinics across the country, and we have seen the number of people on HCV treatment increase from 300 per year in 2013 to 3,000 per year in 2019. Partnerships in the Hepatitis C PACT will build on successes such as these as we continue to work together to defeat this disease.”

HCV can lead to chronic liver disease, cirrhosis, cancer, and death. Of the 58 million people with chronic HCV, an estimated 9.4 million people have been effectively cured.