On 2 April 2018, an in-depth commentary on practical actions that can help increase access to HCV direct-action antivirals (DAAs) was published in a special issue of the Journal of the International AIDS Society (JIAS).
The article – titled Treatment advocate tactics to expand access to antiviral therapy for HIV and viral hepatitis C in low- to high-income settings: making sure no one is left behind – was written by a group of advocates from Medecins du Monde, Initiative for Access, Medicines and Knowledge (I-MAK), the International Treatment Preparedness Coalition (ITPC), Alliance for Public Health, FixHepC, European AIDS Treatment Group, Drugs for Neglected Diseases initiative (DNDi), and the International AIDS Society.
The articles states how: “Worldwide, 71 million people are infected with hepatitis C virus (HCV), which, without treatment, can lead to liver failure or hepatocellular carcinoma… A 12-week course of HCV direct-acting antivirals (DAAs) usually cures HCV – regardless of HIV status. However, patents and high prices have created access barriers for people living with HCV, especially people who inject drugs (PWID).”
It makes the point that most middle-income countries with large burdens of HCV infection and HIV/HCV co-infection are excluded from agreements enable low-income (and some lower-middle income countries) to buy generic versions of HIV and HCV medicines. The commentary presents tactics from the HIV experience that treatment advocates can use to expand access to DAAs.
Actions from the HIV experience that treatment advocates can use to expand access to DAAs, including new research and development (R&D) paradigms; compassionate use, named-patient and early access programmes; use of TRIPS flexibilities such as compulsory licenses and patent oppositions; and parallel importation via buyers’ clubs. The article demonstrates how these approaches can increase access to antiviral therapy for people living with HIV and viral hepatitis in low-, middle- and high-income settings.
ITPC, which leads the Make Medicines Affordable campaign, looks forward to continuing to make contributions to this body of work.