On September 26, 2018, Alliance for Public Health held a final meeting of the partners involved in implementation of the project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine” to present the results of the most large-scale program of hepatitis C treatment in Ukraine. Speeches were delivered by representatives of the Ministry of Health (MoH), the World Health Organization (WHO), the Public Health Center of the MoH of Ukraine, and the US Centers for Disease Control and Prevention (CDC). In the course of interactive discussions, doctors and representatives of civil society organizations shared their experience in treatment and support of the project patients. Success stories of the happy patients cured thanks to the project moved all those present at the meeting.
Until recently, treatment of hepatitis C-infection was not on the donors’ list of priorities: none of the international donors funded hepatitis C treatment, while substantial funding was allocated for HIV treatment. However, with no hepatitis C treatment available thousands of members of key populations were doomed to death. The main obstacle for funding was an exorbitant price of the modern therapy – in United States it was as high as USD 86,000 per three-month course.
However, Alliance for Public Health was able to turn the tide in 2014. Thanks to our persistent and targeted efforts, we managed to ensure the price of hepatitis C treatment at 1% of its cost in the United States. For Ukraine, it was a tipping point in hepatitis C-infection treatment – by purchasing the first consignments of drugs at USD 300 per pack, Alliance set the bar for further drastic decrease of public procurement prices. Today, this price remains unchanged – one course of treatment with original drugs (for 3 months) per person costs the Ukrainian government about USD 900. This price is one of the lowest in the world to purchase modern drugs for hepatitis C treatment. At the meeting Michael Martin from the US Centers for Disease Control and Prevention pointed out that in the United States one tablet of direct-acting antivirals (DAAs) costs one thousand US dollars.
The unique hepatitis C treatment project implemented by Alliance was highly praised by the World Health Organization and the Ministry of Health of Ukraine. Dr Oleksiy Bobryk from the WHO underlined that Alliance was the first to build the foundation for further scale-up of hepatitis C treatment at the national level.
It was Alliance who started using highly effective treatment of hepatitis C with direct-acting antivirals within its project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine” when almost nobody in Ukraine heard about it. Alliance was the first to introduce not only Sovaldi, but even a more innovative drug – Harvoni – within this project. The advantage of those drugs is that they are well tolerated by patients and have almost no side effects, while demonstrating very high treatment success rates! Alliance used those innovative drugs to treat high-priority populations: members of the most marginalized groups with complicated forms of hepatitis C-infection.
2,162 patients from among the key populations received hepatitis C treatment with direct-acting antivirals throughout 2015-2018. The biggest achievement of the project was a high treatment success rate at 95%! Those incredible results have been recognized at the international level. Before, treatment success rate of the old regimens used in Ukraine for hepatitis C treatment did not exceed 50%.
Most of the drugs used to treat 2,162 patients were donated by Gilead.
Besides, an international advisory board consisting of globally recognized experts was established within the project “Scaling up Accessible and Effective HCV Treatment Through a Community-Based Treatment Model for Most Vulnerable Populations in Resource-Constrained Ukraine.” Those experts were involved in the development of the project guidelines, which are currently used as the basis for the current national protocol of hepatitis C treatment.
In 2017, for the first time in Ukraine prisoners also got access to hepatitis C treatment. Within the program, Alliance successfully treated 50 patients in penal settings.
“This is the first time we use this new and unusual term – trendsetter – to describe this project of Alliance. The project for the first time allowed to access innovative treatment with direct-acting antivirals – Sovaldi and Harvoni, reduce the price for modern drugs, implement such a large-scale hepatitis C treatment program in Ukraine, ensure access to the therapy in penal settings, and achieve an incredible treatment success rate of 95%! Those are the trends, which the government not only can, but also must take over and develop! The Alliance project gave us all the evidence necessary to approve a strategic action plan to eliminate hepatitis in Ukraine,” sums up the project successes the Executive Director of Alliance for Public Health Andriy Klepikov.
Alliance would like to thank all those involved in project implementation: Public Health Center and the Ministry of Health of Ukraine, State Penitentiary Service, WHO, CDC, The Global Fund, Gilead Sciences, Yale University as well as all infectious disease doctors, partner organizations and patients. This is our joint victory!