By: Marcus J. Hopkins, Blogger
Much of what HEAL Blog has focused on, over the past two years, has been related to issues of access and the affordability of recent Hepatitis C (HCV) drugs. We’ve written extensively on the subject of domestic coverage options for HCV, but haven’t paid much attention to some of the fantastic strides that are being made on the international front in terms of financing State and organizational treatment programs. This is largely due to the fact that HEAL Blog is primarily written with the North American – specifically American – audiences in mind.
While it’s true that the high price tags associated with HCV drugs are global, those prices are relative to each country around the world. Because United States citizens largely lack access to the comprehensive universal healthcare models that most First World citizens enjoy, we are continually shocked at the skyrocketing costs of innovative drugs. Many nations with universal healthcare coverage have laws or regulations in place that largely prevent the price gouging that we see in America, and yet, relative to the costs of most treatments in their systems, these nations are still appalled that HCV drugs (in particular) are so prohibitively expensive.
These discussions are vitally important, as they get to the heart of what healthcare is about – healing. How First World nations’ citizens pay for and access these life saving medications is fundamental in comparing the U.S. to other great nations in the world. But, when we leave the First World behind, the landscape for addressing healthcare issues becomes much less rosy in developing countries.
Developing countries have a long and storied history of being recipients of aid for various causes, most notably in relation to HIV/AIDS. As citizens of First World nations, we aren’t so frequently reminded of the critical challenges faced by those less fortunate than ourselves – an endemic symptom of cultural exceptionalism and elitism – and when these critical health disparities are brought to our attention, we have a tendency to want to play the “White Knight.” For some reason, we feel that we need to swoop into these nations and “fix” all of their problems, bringing “Developed” approaches and mindsets into “Undeveloped” cultures, and expecting to save the day. What we often fail to realize is that this kind of approach – “We’re giving you this gift; be grateful, damn it!” – is rarely successful in achieving long-term, sustainable healthcare outcomes.
This is where organizations like the Global Fund step in.
The Global Fund (TGF) is a 21st-century partnership organization designed to accelerate the end of AIDS, tuberculosis, and malaria as epidemics, raising and investing nearly $4 billion every year to support programs run by local experts in communities and countries most in need. They serve not as a direct caregiving organization, but as a financing institution for new or existing healthcare models and strategies that are locally run. This allows countries the autonomy to take the lead in determining where and how to best fight diseases, how to respond to broader development challenges, and how to coordinate work with international partners in global health (Global Fund, 2015).
In November 2014, the Board of TGF approved an interim measure for continued funding of HCV virus treatment efforts in areas where co-infection is, for whatever reason, high. This allowed for some of the most vulnerable populations to receive drugs to which they might never have otherwise had access. At the Thirty-Third Board Meeting in November 2015, it has become the recommendation that TGF create a more permanent framework for combating HCV co-infection.
This type of action is much welcomed by those of us at the Community Access National Network (CANN) and the HEAL Blog, as it represents a larger commitment to combating HIV/HCV co-infection on a global scale. HIV patients, in particular, face a heightened danger from HCV-related liver cirrhosis, disease, and failure – HCV is now the leading cause of non-AIDS-related death within HIV-infected populations in many countries – and as such, we should embrace with open arms any efforts to adequately address the epidemic.
Organizations and programs funded by TGF have a far higher likelihood of success than foreign-led efforts in developing countries, and their outcomes are often longer sustained and greater impacting, as community members are more likely to become involved with and fight to maintain and sustain these programs in perpetuity. It is the sincerest hope that the Thirty-Third meeting of the Board will see the passage of these recommendations, and we look forward to reporting more on this subject as the information becomes available.
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.