World Hepatitis Alliance warns of Over-Reliance on Breakthrough Treatments

by hilary campbell

In the run-up to the 67th World Health Assembly, leading hepatitis NGO presses for more focus on prevention

New drugs with 90% cure rates are revolutionising treatment for hepatitis C. Safer and with easier, shorter regimens, they offer the possibility of dramatically cutting the death toll from hepatitis C, estimated at 500,000 a year. As a consequence they have been at the centre of a media storm over the past months, with international calls for widespread access and considerable reductions in price. However the World Hepatitis Alliance, an international patient organisation, has warned that global health leaders are allowing their focus to be diverted too far onto treatment and are dangerously neglecting essential prevention efforts.  As the 67th World Health Assembly approaches, when a new resolution on viral hepatitis will be put forward for debate, the Alliance is urging World Health Organization Member States to give prevention of hepatitis C as much prominence as access to the new therapies.

Without investment in prevention, there is a high risk that governments will abandon treatment programs when the results are not as hoped. “There are 150 million people living with hepatitis C and even treating a fraction of them will require huge investment from governments, who will be looking not just to reduce deaths but also for decreasing prevalence rates to justify the cost” said Charles Gore, President of the World Hepatitis Alliance. “If prevention is neglected and governments see no progress towards reducing the numbers infected, I fear they will lose the appetite to continue funding these new drugs. When the World Health Organization debates the proposed viral hepatitis resolution next week it is critical that not only is hepatitis prevention promoted but that a mechanism is put in place to establish goals and a system of monitoring action”

Although effective evidence-based prevention measures do exist, many countries are still lagging behind in their implementation, resulting in an estimated 3-4 million new infections every year. Not all countries test donated blood for hepatitis C and not all those that do use reliable tests; there is widespread reuse and improper sterilisation of syringes and other equipment in healthcare; few countries have adequate harm reduction measures for people who inject drugs.

Despite the lack of resources and international support, the significance of widespread prevention measures is beginning to be recognised by Governments. Amongst those calling for increased WHO leadership on viral hepatitis prevention is Pakistan, where almost 8% of the population is infected. Health Minister Saira Afzal Tarar said it is essential to “avoid unnecessary injections and reuse of syringes to prevent hepatitis”. Pakistan is expected to be one of many governments to make an intervention at the World Health Assembly next week.

“Right now there is a huge momentum for action” said Charles Gore. “We absolutely mustn’t lose that by taking a one-dimensional approach. The new drugs could be game-changing, but we must see governments and the WHO emphasising prevention as a key part of healthcare systems if the drugs are going to make the global impact we’re hoping for.”

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