AIDS 2012: Call for access to HCV treatment

Michel Kazatchkine, appointed as the UN Secretary-General's new Special Envoy for HIV/AIDS in Eastern Europe and Central Asia (EECA) before the XIX International AIDS Conference (AIDS 2012) opened in Washington DC, responded to a suggestion during a meeting with EECA conference participants to emphasize access to HCV care, noting that the region’s epidemic is not only a dual epidemic of HIV and drug use but rather a quadruple epidemic of HIV, drug use, TB and HCV. Similar dynamics are seen many countries Eastern Europe and Asia where sharing unsterile injecting equipment is driving HIV epidemics. 

During a press conference on HCV treatment access issues co-hosted by the International Treatment Preparedness Coalition (ITPC), Asia Pacific Network of PLHIV (APN+) and Citizen News Service (CNS), rates of HCV infection in EECA among people who inject drugs tend to range from 50% - 70% and are as high as 90% in some cities according to a report recently published by the Eurasian Harm Reduction Network (EHRN).  Similar rates are reported in India by Eldred Tellis of Sankalp Rehabilitation Trust and ITPC India. An ITPC India report on HCV treatment access issues was also released. In spite of high rates of infection, access to HCV diagnostics and treatment remains dangerously low.

Barriers to access to HCV care reported in India and EECA discussed at the press conference were similar and included: lack of access to testing and diagnostics; lack of explicit public health programming targeting HCV; inadequate medical guidelines for HCV treatment; and first and foremost, the high cost of treatment.  Treatment with pegylated interferon usually costs around USD 15000 per patient for a 48 week course though price negotiations can reduce prices.  According to the EHRN, in Georgia for example, the cost of was reduced to USD 6760 per patient for a 48 week course of Merk’s Pegintron.  

In various forums at the conference, participants were reminded that  pegylated interferon will soon go off patent and with generic competition prices can be expected to fall.  But, new medicines with significantly better treatment outcomes, currently in the pipeline, will soon come on to market and they are expected to be even more expensive than the last generation of medicines so the struggle to lower prices will continue.  

Activists were not silent about HCV at the conference. Angered by the pharmaceutical industries’ HCV medicine profiteering, they visited a scientific session hosted by Roche, and gave the company’s representatives a (pig) liver, chanting, “Pharma greed kills!” and “Stop eating our livers!”  

During the conference, the Eurasian Harm Reduction Network gathered signatures on the “HCV treatment waiting list” a petition demanding access to HCV treatment which it delivered to the World Health Organization, as well as the producers of  pegylated interferon, Merck and F. Hoffmann La Roche on World Hepatitis Day which took place right after the conference. 

Most significantly, during the conference and on the eve of world hepatitis day, an international coalition of organizations advocating for universal access to HCV voluntary testing and treatment was formed.  The group issued the “Washington Call for Access to HCV Diagnostics, Treatment and Care for All!” in which it demands that pharmaceutical companies lower prices; political leaders mobilize resources; WHO develop treatment guidelines and prepare to prequalify generics of the HCV drugs which will soon be off patent and for donors and communities to mobilize for treatment preparedness and advocacy.    

Shona Schonning - CNS