Clinton Health Access Initiative, Inc.

Eliminating Hepatitis C: Saving millions from the ‘silent killer’ Highly Ranked

Lead Organization

Clinton Health Access Initiative, Inc.

Boston, Arkansas, United States

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Project Summary

Seventy-one million people worldwide are infected with Hepatitis C (HCV), a blood-borne virus known as the ‘silent killer’ due to the long period before people experience symptoms. The epidemic is growing, with 1.75 million new infections and more than 400,000 deaths per year from cirrhosis and liver cancer. A revolutionary treatment developed recently cures 95% of people in weeks with a once daily pill. There is global commitment to eliminate HCV by 2030, and tools exist to do it, but the current haphazard “control” response, waiting to treat people until they become symptomatic, will solidify this as an epidemic that lasts centuries, much like tuberculosis.Working hand in hand with twelve governments towards curing over 9 million people and averting close to one million new infections, CHAI will put the world on track to end HCV forever, and banish the skepticism that this epidemic can be eliminated practically and affordably.

Problem Statement

Approximately seventy-one million people are infected with hepatitis C virus (HCV) – roughly twice as many as those living with HIV. The virus is transmitted through contact with infected blood and the epidemic continues to grow, with drug use, incarceration, unsafe medical procedures, and lack of infection control in everyday practices (i.e. haircuts, tattooing, piercings, etc.) unknowingly putting people at risk. Left untreated, HCV can lead to cirrhosis, liver cancer, and death. The most affected and at-risk populations include commonly marginalized populations (people who inject drugs, people living with HIV, men who have sex with men, sex workers, poor people who cannot afford high quality medical and dental care, migrants and prisoners). Simple, affordable and effective tools are now available to diagnose, cure and prevent HCV infections. Despite millions of people being cured in rich countries since the introduction of Direct Acting Antivirals (DAAs) – the cure - their practical application in poor countries to fully eliminate the disease has yet to be established. Without being shown a credible path to elimination, potential funders remain on the side-lines despite the cost to eliminate HCV in poor countries ($12 billion USD) being less than that of a single year’s global HIV budget ($20 billion USD). With resources from the MacArthur Foundation, CHAI will generate out-sized returns on the project investment by galvanizing donor and government action through working with early-adopter governments to show how HCV can be eliminated effectively, efficiently and affordably.

Solution Overview

CHAI will partner with governments to achieve HCV elimination in 2 countries within 5 years and set 10 additional countries on a path to elimination by 2030. This program will demonstrate to the global community that HCV elimination can be achieved in poor countries for less than half of the total spend on HIV programs per year.CHAI will support governments to strengthen, simplify, and decentralize systems to test smart, cure all people living with HCV, and prevent new infections. Together with WHO, CHAI will help Ministries of Health to integrate HCV into existing M&E systems and ensure robust collection and analysis of data at the central level – facilitating informed decision-making and accurate progress-tracking.CHAI will leverage the buying power of MacArthur resources to negotiate lower pricing for medicines and diagnostics and to mobilize additional government and donor resources. Across all twelve project countries, the work will culminate in the cure of up to 9.2 million people, averting more than 967,000 new infections and 543,000 deaths, while addressing one in every four HCV cases in poor countries.Studies show distribution of new HCV cases among younger, primarily male marginalized populations, including prisoners, refugees, people who inject drugs (PWID), men who have sex with men (MSM), and persons experiencing homelessness, as well as an older cluster at significant risk of cirrhosis and cancer infected before screening and sterilization procedures were in place in the mid-to-late 1990’s.

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Project Funders

  • UK Department for International Development 2015 - 2020
  • World Hepatitis Alliance 2018 - 2019
  • Foundation for Innovative New Diagnostics (FIND) 2018 - 2020

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