Treatment of hepatitis C has more than doubled since 2013. Yet 99% of people are still being denied the life-saving cure

28 Jul 2016 Bridie Taylor

On World Hepatitis Day, the World Hepatitis Alliance is calling for a dramatic scale up in testing and treatment across all countries to reduce the global burden

London, 28 July 2016 – New research from Polaris Observatory shows that out of the 71 million they estimate are infected, 950,000 were treated for hepatitis C in 2015, compared to 440,000 in 2013. [i]

In total, the hepatitis viruses are the seventh leading cause of mortality, responsible for 1.4 million deaths each year – more than AIDs, TB or malaria.[ii] Hepatitis C is responsible for half of this huge number, killing more than 700,000 people every year, mostly as a result of liver disease, cirrhosis or liver cancer.

Despite the fact that treatment rates have increased since 2013, only 1% of people with hepatitis C received treatment in 2015, and more than a third of those received older and less effective therapies.i

“We have the right to be cured of a cancer-causing virus” said Raquel Peck, CEO of World Hepatitis Alliance. “If things remain the same, it will take close to 100 years to cure everyone using current treatment and cure rates. On World Hepatitis Day, we are calling on governments to step up and take the necessary measures to provide preventative and curative treatment”.

According to Polaris Observatory[i]:

  • Four countries (France, Germany, Netherlands and Spain) have the highest treatment rates worldwide, with over 10% of hepatitis C patients receiving treatment.
  • African countries, including Ghana and Nigeria, have the lowest treatment rates (less than .01%).
  • Countries lagging behind include the UK, who, despite having low prevalence rates compared to other countries, treat less than 5% of patients.
  • China and India are failing to treat more than 1% of patients, despite them having the largest numbers of people living with hepatitis C and the availability of generics in India are priced at a fraction of the cost of the branded drugs.
  • Out of the 950,000 people treated in 2015, only 600,000 were treated with directly acting antivirals (DAAs), fast-acting and highly-effective therapies.
  • 75% of people receiving DAAs lived in the US and Egypt and these two countries along with Spain, Pakistan, Germany and France accounted for 94% of all patients treated with the new DAA therapies.

When the highly-effective DAAs or “hepatitis C cure” were first launched, the high costs associated with them were often cited as the reason for these low treatment rates. However, with increased competition amongst manufacturers, the availability of generics and direct negotiations between governments and suppliers, hepatitis C prices are falling, although in many parts of the world, not fast enough.

Already this year, Australia and France have signed deals to increase access to these life-saving medicines. The Australian government negotiated a unique volume-based price agreement with pharmaceutical companies to treat 62,000 people at a cost of AUS$1 billion over five years – an average price per treatment of AUS$16,129 (US$11,715 / £8234) if all 62,000 people are treated. So far, an estimated 13,000 to 16,250 patients had started treatment since the drugs were first listed in March. In France, from September 2016 everyone diagnosed with hepatitis C will be provided with DAAs and everyone with stage 2 fibrosis will begin treatment immediately.

According to World Health Organization there are other significant factors affecting treatment rates, namely diagnosis and surveillance. Globally, less than 5% of people living with hepatitis are aware of their illness.i

“We estimate that in the past year, only 300 000 people living with hepatitis C in low- and middle-income countries were treated. There are still many barriers preventing people from accessing treatment services, including low testing rates and high prices of drugs. But we are also seeing how some countries and communities are finding solutions to overcome these barriers,” said Dr Gottfried Hirnschall, Director of the HIV/AIDS Department and the Global Hepatitis Programme (GHP) of the World Health Organization. “WHO is urging countries to “Know Hepatitis” on World Hepatitis Day. We want people to learn about hepatitis, be tested and demand treatment.”

Governments will need to move beyond using cost as an excuse not to treat and develop bespoke strategies to increase access, which may include fostering generic competition through voluntary licensing, making use of the flexibilities permitted under the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), differential pricing and direct negotiations with suppliers. They will also need to increase access to cheaper diagnostics and scale up testing, if they are to meet the targets outlined in the WHO Global Viral Hepatitis Strategy.

The Strategy, which was adopted in May, committed governments to reach a target of treating 80% of people by 2030 and an overarching goal of eliminating viral hepatitis.[iv]

To ensure governments take the necessary steps to meet the targets, the World Hepatitis Alliance together with a large number of civil society organisations launched “NOhep”, the global movement to eliminate viral hepatitis. NOhep aims to unite those working in the field of hepatitis and others from across the world around one common purpose: the elimination of viral hepatitis by 2030. Today, on World Hepatitis Day, NOhep is calling on individuals and organisations across the world to sign-up to be part of the next greatest achievement, the elimination of viral hepatitis. Sign up and watch the video here:
“Join us today, on World Hepatitis Day, to call on governments to take the first step towards eliminating hepatitis by ensuring the millions of people living with the virus have access to life-saving treatment. Because only then we will have a world with “NOhep”. said Raquel Peck

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About Viral Hepatitis
Viral hepatitis is inflammation of the liver caused by a virus, and globally kills more than 1.4 million people every year. There are five different hepatitis viruses - hepatitis A, B, C, D and E. Hepatitis A is spread mainly through ingestion of contaminated food and water and there are an estimated 1.4 million cases each year. Hepatitis B is transmitted through contact with the blood or other bodily fluids of an infected person and approximately 240 million people are living with chronic infections. Hepatitis C is mainly spread through blood-to-blood contact such as unsafe injection practices and inadequate sterilisation of medical equipment. Hepatitis D is passed on through contact with infected blood and only occurs in people who are already infected with hepatitis B. Hepatitis E, like hepatitis A, is transmitted through ingesting contaminated food or water.

World Hepatitis Day
About World Hepatitis Day World Hepatitis Day is one of only four official disease-specific world health days recognised by WHO. World Hepatitis Day was launched by the World Hepatitis Alliance in 2008 in response to concern about the lack of priority for hepatitis as a global killer and became an official WHO day in 2010 at the 63rd World Health Assembly. For World Hepatitis Day 2016 the World Hepatitis Alliance launched NOhep, a global movement aimed at uniting people from across the world to take action, to speak out and be engaged to ensure viral hepatitis is eliminated by 2030. In addition, NOhep provides a platform for the hepatitis community to share resources and materials so that actions can be taken to eliminate viral hepatitis. The fundamental objective of NOhep is to build awareness of viral hepatitis and the crucial role people can play, in their own lives, at more structural levels and in their communities, to help eliminate viral hepatitis by 2030.

The World Hepatitis Alliance
The World Hepatitis Alliance (WHA) is a patient-led and patient driven non-governmental organisation (NGO). With over 230 member patient groups from 82 countries, WHA provides global leadership to drive action to help eliminate viral hepatitis as a public health threat by 2030. Their aim is to work with governments, members and other key partners to support and elevate patient voices, to raise the profile of viral hepatitis and to help establish comprehensive hepatitis strategies which have robust prevention measures and access to affordable diagnostics and treatment.

Centre for Disease Analysis
The Centre for Disease Analysis (CDA), which is based in Louisville CO, USA, specialises in studying complex and poorly understood diseases. Its main goal is to study and publish data to help educate stakeholders and support decision-making in different countries. Since 2008, CDA has been quantifying the epidemiology of HCV and HBV and forecast the future impact of these infections. They have analysed HCV disease burden in over seventy countries and have helped countries develop national strategies. You can find out more here.

[i] Polaris Observatory, "A Delphi process (using published literature followed by interviews with local experts) was used to gather data for 59 countries (“Approved”). Literature search was used for the remaining countries (“Estimated”). High quality HCV data were available for 41 countries, bringing the number of validated or estimated models included up to 100. These countries account for 85% of the global population and viremic infections. In 2016, there were an estimated 71 million viremic infections, globally, corresponding to a viremic prevalence of 0.96%."More information at:
[ii] Stanaway et al, The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013, Lancet, July 2016
i World Health Organization, Draft global health sector strategy on viral hepatitis 2016-2021, November 2015
[iv] Imperial College Applied Modelling Group. Global investment case document. Unpublished report commissioned by WHO´s Global Hepatitis Programme.