WHO Passes Hepatitis Resolution to Fight Global Pandemic

Megan Brooks

May 22, 2014

The World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO), passed a new hepatitis resolution today that commits the WHO and United Nations (UN) member states to "urgent action" to address the global hepatitis pandemic, including that of hepatitis C virus (HCV), according to a press statements from WHO and the Treatment Action Group (TAG).

In 2010, the WHA first adopted a hepatitis resolution, which called for a comprehensive approach to the prevention and control of viral hepatitis.

An estimated 185 million people are infected with HCV worldwide, and since 2010, more than 1 million have died from HCV-related liver disease, although HCV is treatable and curable, the TAG said today.

Since 2010, up to 12 million people have become infected with the virus, although it is preventable. In addition, in an increasing number of countries, liver disease caused by HCV has become the leading cause of non-AIDS-related death in people coinfected with HIV/HCV.

The new resolution "comes at a critical moment," the TAG says, as new direct-acting antivirals (DAAs) are entering the market. These new drugs have cure rates of more than 90% in clinical trials and provide much simpler treatment. DAAs offer the "unprecedented promise of global HCV eradication," especially in low- and middle-income countries, where 85% of people with HCV live.

Yet, as Malaysia, Ukraine, South Africa, Venezuela, and France noted during the resolution proceedings, the cost of DAA treatment is prohibitive. A 12-week combination regimen of DAA treatment can cost $140,000, according to the TAG, although it costs less than $250 to produce.

The hepatitis resolution supports use of "legal flexibilities" outlined in the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to produce or import generic versions of DAAs and other medications if companies refuse to offer them at affordable prices, according to the TAG.

"The WHO must vocally and unequivocally support countries' use of compulsory licenses, parallel importation, and other TRIPS flexibilities to facilitate universal access to lifesaving treatment and to stop the 500,000 annual deaths related to HCV," the TAG says.

The new resolution retains the inclusion of harm reduction, an evidence-based approach to reducing transmission of bloodborne viruses and mortality among people who inject drugs (PWID), as a key recommendation.

"Now the WHO must prioritize providing technical assistance to UN member states to dramatically scale up needle and syringe programs, opioid substitution therapy, access to HCV treatment, and decriminalization of PWID and harm reduction for this critically important population, 67% of whom are HCV-infected," the TAG notes.

"Most new infections occur among PWID, yet access to sterile injection equipment and other HCV prevention tools is staggeringly inadequate, reaching only a tiny percentage of those who need it. This egregious public health failure allows the epidemic to continue spreading," the TAG says.

The new resolution challenges WHO Director-General Margaret Chan, MD, and the WHO to "mobilize global political will and resources to effectively address viral hepatitis, and to help UN member states develop the technical capacity to implement prevention, treatment, and care plans. Without a massive resource investment from donors and UN member states to support a global plan, millions will continue to become infected and die," the TAG says.

"Defuse Hepatitis C, the Viral Time Bomb: Test and Treat Hepatitis C: Position Paper for the 67th World Health Assembly." WHA. Full text

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