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Global HCV/HIV Coinfection Treatment Access Demanded
 
 
  WHA Resolution that recognizes Hepatitis C as a public health issue should be used in advocacy efforts to improve access to Hepatitis C treatment.
 
Thai Aids Treatment Action Group
... in Round 10-11 Global Fund grants, and community actions on July 28, the new annual "World Hepatitis Day." .... To read the coinfection education and advocacy manual developed by TTAG and TAG over the past two years, write to TTAG : ... www.ttag.info/
 
There are two main obstacles to HCV treatment. First is the expensive cost of the treatment; second is the lack of education and understanding around HCV and how to treat it--from injecting drug users (IDU), the most at-risk group, as well as other patients, and medical providers, policymakers and Thai activists
 
The high cost of Hepatitis C treatment makes it almost impossible for people with Hepatitis C to get the treatment they need. Treatment cost varies from US$ 14,000 to US$ 33,000. In Nepal, however, treatment for Hepatitis C is not yet available and Hepatitis C patients are referred to India for treatment. Pegylated Interferon is patented by Roche (Pegasys) and Schering-Plough (PegIntron). Because these two pharmaceutical companies are holding patents, the cost for treatment is extremely high. There is a need to identify specific advocacy campaigns to lower treatment costs.
 
The meeting discussed the need to use TRIPS flexibility such as Compulsory Licensing (CL), as well patent oppositions, to drive down the cost of Hepatitis C treatment. It is unclear when the patents for pegylated interferon will expire. Thus, better information about the current patent status of pegylated interferon is needed in each country.
 
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Hepatitis C, the "silent killer," threatens to undermine HIV prevention and treatment efforts in Thailand, says Thai AIDS Treatment Action Group (TTAG) Foundation
 
28/07/2010 9:41 am
 
(Bangkok - July 28, 2010): Today, in recognition of the new World Health Organization (WHO) endorsement of July 28 as World Hepatitis Day, the Thai AIDS Treatment Action Group (TTAG) Foundation, a community-based advocacy organization, released a policy report outlining the public health crisis of HIV and hepatitis C (HCV) co-infection in people who inject drugs in Thailand (available in English and Thai at www.ttag.info). The report, entitled "Illuminating a Hidden Epidemic: The Public Health Crisis of HIV/HCV Co-infection Among Injecting Drug Users (IDU) in Thailand," offers recommendations to the government to help stop and reverse this dual epidemic.
 
HIV prevalence among injectors has hovered at 50% for nearly two decades; HCV prevalence among injectors is approximately 90%. This dual epidemic threatens to undermine Thailand's goal of "universal access" to effective HIV prevention, treatment and care and is facilitated by a lack of an enabling legal, social, and policy environment in which UNAIDS insists universal access must be promoted.
 
Paisan Suwannawong, TTAG's founder and living with HIV for 20 years stated: "The government says it treats people who use drugs as 'patients,' not 'criminals,' but where's the evidence? In reality, we are still being imprisoned and forced into compulsory drug treatment camps that do not provide the kind of support we need. At the same time, the government fails to implement evidence-based approaches to HIV prevention for drug users, such as comprehensive services that include access to clean injecting equipment and methadone maintenance therapy. It is no wonder the dual HIV/HCV crisis continues to wipe us out."
 
HCV, a curable disease, is the world's leading cause of liver disease. Globally, at least 180 million people - 3% of the world's population - are infected. In Thailand, approximately 2% of the population is living with HCV; over 90% of injectors are estimated as infected. HCV is much smaller and 10x more infectious than HIV, and primarily transmitted by blood.
 
TTAG's report outlines the scope of the problem of HIV and HCV in the general population and most importantly among injectors, and provides policy recommendations to help urgently stop and reverse this epidemic so both HIV and HCV can be successfully eradicated. Some of the key recommendations include:
 
- Immediately scale up evidence-based harm reduction programs that promote access to clean injecting equipment/sterile syringes, which prevent new HCV infection; - Increase political support for the Thai Government Pharmaceutical Organization (GPO) to produce generic versions of pegylated interferon and ribavirin, the current WHO-endorsed standard of care; and = Increase political support for Thai government officials to exercise legal flexibilities including compulsory licenses and parallel importation to gain access to cheaper HCV treatment.
 
Wirat Purahong, TTAG's HIV/HCV Treatment Access Campaign coordinator, said: "Though HCV can be cured in many, including in people living with HIV, in just 48 weeks, the cost of all the related tests and treatment currently costs over 1 million Thai baht per person. How can we enjoy our right to health if the pharmaceutical companies are thinking only of their right to profit?"
 
Thai HIVHCV Policy Brief.pdf - 1 Illuminating a Hidden Epidemic ...
File Format: PDF/Adobe Acrobat - Quick View Feb 10, 2010 ... Illuminating a Hidden Epidemic: The Public Health Crisis of HIV/HCV Co-infection Among Injecting Drug Users (IDU) in. Thailand ... www.idpc.net/sites/default/files/.../Thai%20HIVHCV%20Policy%20Brief.pdf
 
Policy Recommendations
 
In order to successfully tackle the challenges faced by Thai IDU who are co-infected with HIV and HCV, policymakers should:
 
· Immediately scale up evidence-based harm reduction programs that promote access to clean injecting equipment/sterile syringes, which prevent new HCV infection,
 
· Increase support for Thai civil society involvement in HCV awareness campaigns through promotion of capacity building and education of advocates, patients, healthcare providers, and policymakers,
 
· Provide universal access to free testing for HCV and offer follow-up diagnostic tests on a routine basis to IDU who test positive for HIV, · Provide national level data collection on HCV incidence and prevalence among Thais living with HIV/AIDS,
 
· Include pegylated interferon and ribavirin on WHO and Thai Essential Medicines Lists,
 
· Develop Thai-language national guidelines based on international best practices for HCV treatment and care,
 
· Increase political support for the Thai Government Pharmaceutical Organization (GPO) to produce generic versions of pegylated interferon and ribavirin, and
 
· Increase political support for Thai government officials to exercise legal, TRIPS flexibilities (such as compulsory licenses and parallel importation) to gain access to cheaper HCV treatment
 
 
 
 
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