WHO highlights progress in accelerating access to hepatitis C diagnosis and treatment in low- and middle-income countries

Many low- and middle-income countries have reduced their incidence of hepatitis C, thanks to increased access to testing and treatment. Some achieved a twenty-fold increase in the number of people treated with safe and effective direct-acting retroviral drugs between 2015 and 2018, according to Report on global progress in accelerating access to hepatitis C diagnosis and treatment, published by WHO today.

The decline in success is supported by the decline in prices

Low- and middle-income countries can now aim to fetch as much as $ 60 per patient for a 12-week course of treatment with generic sofosbuvir and daclatasvir previously qualified by the WHO. Prices offered by suppliers of rapid diagnostic tests of HCV with overqualified WHO ranged between 1 and 8 US dollars per test.

By 2018, more than 120 countries had adopted a national viral hepatitis strategy, compared to 20 in 2012. This has accelerated since the adoption of the first World Health Sector Strategy on Viral Hepatitis 2016-2021, with a number of countries making impressive progress to increase their commitment. governments, develop national strategic plans, simplify guidelines, and increase the availability of cheaper, well-secured diagnostic and treatment options.

Despite the challenges of the ongoing COVID-19 pandemic, the progress made to date is impressive but fragile, and access to hepatitis C testing and treatment has not reached a sufficient level of coverage to achieve the global goal of eliminating viral hepatitis as a major public health threat by 2030. At the end of 2017, only 5 million – or 7% – of the 71 (62–79) million people chronically infected with HCV were cumulatively treated with direct-acting antivirals.

“While countries continue to cope with the burden of disease and service disruptions caused by the COVID-19 pandemic, it is crucial to ensure that recent momentum and gains in response to hepatitis C are not lost.” said Dr. Minghui Ren, WHO Assistant Director-General for Universal Health Coverage of Infectious and Noncommunicable Diseases. “Global efforts to expand access to high-performance interventions against hepatitis C must be sustained and accelerated over the next decade, as part of a broader effort toward universal health coverage.”

“Sources of generic antivirus products and quality-assured diagnostics are constantly increasing, and prices continue to fall,” said Dr. Mariangela Simao, Assistant Director General for Access to Medicines and Health Products at the WHO. “However, many countries do not access these low prices. Greater market transparency, together with guidance and exchange of experiences from around the world, provide practical examples for countries and communities to expand access and address persistent barriers. ”

Despite the recent fall in prices, the availability and affordability of diagnostics remain a major obstacle to expanding treatment in low- and middle-income countries. It will be important to expand access to simple, cost-effective and high-quality in vitro diagnosis of hepatitis C so that countries can screen large numbers of people, identify patients in need of treatment and provide appropriate care.

“Accelerating universal access to diagnostic tests for hepatitis and multi-disease diagnostic analyzers that can be used at or near care sites is necessary,” said Dr. Meg Doherty, director of the WHO’s Department of Global HIV, Hepatitis and STI Programs. “We will continue to work with governments, technical partners, civil society and global experts to encourage decentralization, division of tasks, simplification and integration of screening and diagnostic services with existing infrastructure in countries.”