We Can Cure Hepatitis C, But We’re Making the Same Mistake We Did with AIDS Neil Gupta and Paul Farmer - The Washington Post
go to original August 19, 2017

Baby Boomers: Beware of Hepatitis C (Hartford HealthCare)

Three years ago, we wrote about the wide gap in access to hepatitis C treatment, hoping that mistakes made in the world’s response to AIDS would not be repeated in another epidemic of a lethal, blood-borne disease.

Our worst fears have been realized. The World Health Organization now reports that 4 out of 5 people infected with hepatitis C aren’t even aware of it. Of those who do know, fewer than 1 in 50 have received treatment. These numbers are far worse in parts of South Asia and sub-Saharan Africa, where the majority of the global extreme poor live. In many places, such as Rwanda, infected patients remain on waiting lists for treatment, without which many succumb early to liver failure, cancer and other related complications.

Unfortunately, it bears repeating: This is a failure not of science but of delivery.

Hepatitis C presents the world with an epidemic of massive proportions, one that slowly and silently afflicts more than 70 million people worldwide, more than even HIV. It kills one person every 80 seconds, claiming more lives each year than Ebola, Zika and cholera combined.

Scientific investments have already yielded a new class of medications, called direct-acting antivirals, which, among those with access to them, have transformed hepatitis C from a stubborn and difficult-to-treat chronic infection to one that can be rapidly cured.

A magic bullet for a global epidemic? Not yet. The initial prices for these medications have been up to $1,000 per pill in the United States — or more than $84,000 to cure a patient. As expected, such prices triggered anxiety, and sometimes outrage, among patients and families, health-care providers, i nsurers and governments around the world.

There is cause for optimism in some of the world’s more impoverished settings. Several pharmaceutical companies have allowed, and even encouraged, production and sale of generic drugs in poor countries at a fraction of the price charged in richer ones. The same therapies initially released at prohibitive prices in the United States and Europe can now be purchased for less than $500 in some low-income countries. And in several countries, activism by patients, providers and allies has stalled or denied the granting of patents, which may portend even steeper reductions in prices.

Read the rest at The Washington Post

Neil Gupta is an instructor in internal medicine and pediatrics at Harvard Medical School and a clinical director for the nonprofit organization Partners in Health. Paul Farmer is the Kolokotrones university professor at Harvard University, an infectious-disease physician at the Brigham and Women’s Hospital and co-founder of Partners in Health.

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