Ministries of Health in Ethiopia, Indonesia, Myanmar, Nigeria, Rwanda, and Vietnam are accelerating access to hepatitis C (HCV) testing and treatment with technical assistance from the Quick-Start programme, which aims to cure 25,000 people of HCV in the next two years. The Quick-Start programme is a partnership of the Clinton Health Access Initiative, Inc. (CHAI) and Duke Health. The programme is in close collaboration with PharmAccess Foundation, Amsterdam, which is establishing HCV treatment projects in several sub-Saharan African countries.

The Quick-Start programme supports governments to establish successful treatment programs and speed up access to HCV cures. The cornerstone of the programme is a simplified screening and treatment algorithm, developed with Duke’s clinical expertise, in collaboration with leading clinicians from Nigeria, Ethiopia, Kenya, and the Academic Medical Center in Amsterdam, introducing new direct-acting antiviral (DAA) medicines that will improve and enhance clinical impact while reducing costs and allowing for treatment to be prescribed by general clinicians.

“The national viral hepatitis programme in Rwanda is deeply committed to providing access to HCV screening and treatment in its public health facilities and is encouraged to scale up its efforts towards treating patients with more affordable commodities,” stated Dr. Sabin Nsanzimana, head of HIV, STI and Other Blood-Borne Infections Division at the Rwanda Biomedical Center.

In addition, Bristol-Myers Squibb has agreed to donate Daklinza to the Quick-Start programme, as announced on April 13, 2016. CHAI has also signed agreements with Hetero, Mylan, and Roche to significantly reduce the costs of diagnosing and curing people living with HCV at health facilities enrolled in the Quick-Start programme. The supply agreements are a first step toward making treatment more affordable in low- and middle-income countries, reducing the cost of diagnosing and treating patients living with HCV in these countries from US $1,370-$1,570 to US $488-$737 per patient, representing a 45-70 percent reduction in cost. The products included in these agreements are highly-effective, high-quality diagnostics and curative treatments that can be feasibly introduced in low-resource settings while ensuring high quality of care.

“The Government of Nigeria is taking measures to ensure that the burden of HCV, which affects an estimated 3.6 million Nigerians, is remarkably reduced. With decreased costs, Nigeria will be in a better position to ensure a more affordable and sustainable market for HCV medicines and diagnostics that will increase access to diagnosis and treatment for those most in need,” said Dr. Chukwuma Anyaike, head of Prevention, National AIDS and STIs Control Programme of the Federal Ministry of Health of Nigeria.

Global HCV antibody prevalence is estimated at 115 million people, with approximately 80 per cent of cases occurring in low- and middle-income countries. An estimated 700,000 people die each year from HCV-related complications. The countries where this initiative is being launched – Ethiopia, Indonesia, Myanmar, Nigeria, Rwanda, and Vietnam – have as many as 24 million people who are antibody-positive for hepatitis C.

“Today, we are with hepatitis C, where we were at the beginning of the HIV crisis,” said Ira C. Magaziner, CEO of CHAI. “With these pricing agreements, we can begin to stimulate the development of a low-cost, sustainable market for HCV medicines and diagnostics that will drive increased access to treatment across low- and middle-income countries. I commend these governments for their commitment to tackling their epidemics today, before increasing rates of cirrhosis and mortality resulting from HCV overwhelm health systems.”

“Hepatitis C is a major concern in our country and we have taken significant strides to start our comprehensive hepatitis control program, from prevention to treatment. These reduced prices make it affordable for the Government of Indonesia to begin covering the cost of treatment for those most in need,” stated Dr. H. M. Subuh, director general of the Directorate General of Disease Control & Prevention, Ministry of Health in Indonesia.

The products covered in the agreements announced recently include HCV screening tests, viral load tests, and direct-acting antiviral agents. All suppliers of CHAI’s Quick-Start HCV programme have undergone or are currently undergoing review by a stringent regulatory authority (SRA), WHO Prequalification Programme, or an Expert Review Panel for their respective HCV products. The negotiated pricing and supply terms are only valid for products that ultimately meet one of these standards. The details of individual pricing and supply agreements are confidential.

CHAI is a global health organisation committed to strengthening integrated health systems and expanding access to care and treatment in the developing world.