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Hepatitis C: New hope for patients

A non-profit organisation is making headway in its initiative to develop drugs for neglected diseases to benefit those who can’t afford them. New Sunday Times speaks to two medical practitioners who are working towards making affordable Hepatitis C treatment available to local hospitals.

OF the estimated 150 million people infected with chronic Hepatitis C around the world, approximately 75 per cent live in low- to middle-income countries.

However, some countries, including Malaysia, are excluded from the voluntary licensing agreements that the intellectual property holders of the Hepatitis C drugs have concluded with generic pharmaceutical companies.

As a result, new Hepatitis C medicines are very expensive.

“Treatment for Hepatitis C can be as much as US$30,000 (RM128,000) for each therapy.

“Our aim is to develop a treatment that is as good for a fraction of that, possibly under US$300 (RM1,280),” said Drugs for Neglected Diseases Initiative (DNDi) executive director Dr Bernard Pecoul in an interview with the New Sunday Times recently.

DNDi is a collaborative, patients’ needs-driven, non-profit drug research and development organisation that is developing new treat- ments for neglected diseases.

Based in Geneva, Switzerland, it is aimed at improving the quality of life and the health of people suffering from such diseases by using an alternative model to develop drugs for them while ensuring equitable access to new and field-relevant health tools.

Dr Pecoul said DNDi had signed an agreement with the Health Ministry last year to facilitate access to Hepatitis C treatment for Malaysians.

“We plan to conduct clinical trials to test a combination treatment of the drug in pan-genotypic patient populations in countries such as Malaysia and Thailand soon.

“At the moment, we are in the phase of implementing the study involving 220 patients to prove the efficacy of this combination treatment.”

He said DNDi had recently signed agreements with the Egyptian drug manufacturer, Pharco Pharmaceuticals, to cover the clinical testing and scale-up of a Hepatitis C treatment regimen at a price of just under US$300.

Dr Pecoul explained that Egypt was one of the biggest success stories in this new and cost-effective treatment, and hoped to introduce the treatment in countries like Malaysia, Cambodia and Vietnam.

“Although we have excellent proven results from Egypt, we have to realise that Hepatitis C in this region may not exactly be the same as there are different genotypes in the disease.

“So, we are in the process of accumulating and presenting data,” he said.

If the clinical trials were successful, he said, the regimen could soon become part of a public health approach to treat Hepatitis C that would be an alternative to today’s high drug prices and treatment rationing.

“An affordable cure for this deadly disease that treats all strains or ‘genotypes’ is essential to tackling the worldwide Hepatitis C epidemic,” he said.

Hepatitis C is a blood-borne virus (known as HCV). It’s been recorded that there are approximately 500,000 deaths per year from HCV-related liver diseases.

The goal in treating HCV infection is to reduce virus-related complications.

“Today, we have a lot of people waiting for treatment with many looking for an affordable cure.

“This is a cure, so it’s a big advantage.

“Because the disease is transmitted from people to people, curing people is the best way to prevent the dissemination of the disease.”

DNDi Southeast Asia’s regional office head Dr Jean-Michel Piedagnel, who is championing local efforts, said the treatment had seen more than 90 per cent success rate with minimal side effects.

“It’s important for people to realise that Hepatitis C is non-gender specific, nor affected by region.

“And, the worst is that at times, it only shows up after 20 years of being infected.

“So, we see many cases of people seeking treatment between the ages of 40 and 45.

“Right now in Malaysia and around the world, there is a backlog of cases of adults who are unaware of their deadly health situation.”

He said DNDi had been working closely with the relevant authorities, such as the Health Ministry, pharmaceutical companies, Clinical Research Malaysia and universities, as well as the public and private sectors.

Dr Piedagnel said the study would be completed next month or in September, following which, the results would be presented to the authorities.

“It cannot happen overnight as the safety of patients needs to come first and the regulatory framework is strict.

“We hope the treatment will be available in government hospitals next year.

“For now, it’s important for Malaysians to know that the solution and cure are out there, within our reach, if only everyone works together.

“We hope to start the treatment in government hospitals and later make it available at other medical institutions,” he said.

Developing Affordable Treatments for Patients

DRUGS for Neglected Diseases Initiative (DNDi) was formed in 2003 to improve the quality of life and the health of people suffering from neglected diseases by using an alternative model to develop drugs for these diseases, and ensuring equitable access to new and field-relevant health tools.

A non-profit drug research and development (R&D) organisation based in Geneva, Switzerland, its partners include the World Health Organisation and Doctors Without Borders.

In this not-for-profit model, driven by the public sector, a variety of players collaborate to raise awareness of the need to research and develop drugs for neglected diseases that fall outside the scope of market-driven R&D. They build public responsibility and leadership in addressing the needs of these patients.

DNDi’s primary focus has been the development of drugs for the most-neglected diseases such as human African trypanosomiasis (HAT, or sleeping sickness), leishmaniasis and Chagas disease.

It engages in R&D projects for neglected patients affected by certain diseases such as malaria, paediatric HIV, filarial infections, and develops diagnostics or vaccines to address needs that others are unable or unwilling to address.

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