26 July 2023

The importance of public-private partnerships in hepatitis elimination

By Tina Kasap, Account Director, Evoke Incisive Health

World Hepatitis Day is one of only five disease-specific World Health Organization (WHO) recognised global health days. Under the 2023 theme ‘One life, one liver’, WHO highlights the importance of the liver for overall health and reminds stakeholders of the urgent action needed to eliminate this silent killer that continues to claim over one million lives every year. With under a decade left to achieve United Nations (UN) sustainable development goals on hepatitis elimination, there is an urgent need for strengthened collaboration between governments, the private sector and affected communities to eliminate hepatitis as a public health threat.

The long road to elimination

Viral hepatitis is a liver inflammation caused by a group of viruses. Hepatitis B, C and D are responsible for the majority of the disease burden, as they cause chronic inflammation that leads to liver cirrhosis and liver cancer. Currently, over 350 million people worldwide live with these viruses. Fortunately, with a vaccine that prevents hepatitis B and D, and a treatment that cures over 95% of hepatitis C infections, hepatitis elimination can be achieved in under a decade. In 2015, the UN adopted the 2030 Agenda for Sustainable Development, setting out specific goals for governments to eliminate viral hepatitis as a public health threat by 2030. Although there is less than a decade left to eliminate hepatitis, only 11 countries (Australia, Canada, Denmark, Egypt, Finland, France, Georgia, Japan, Norway, Spain and The United Kingdom) are on course to reach this goal. In the 2022 Global Health Sector Strategy on viral hepatitis, WHO calls for greater coordination between affected communities, the public sector, and the private sector as the only way to achieve ambitious elimination targets.

Partnership, partnership, partnership

Public-private partnerships have long played a pivotal role in the fight against viral hepatitis. Just last month, Gavi, a public-private global immunisation partnership, announced that it will start rolling out hepatitis B birth-dose vaccine in low-income countries, which is estimated to prevent up to 1.5 million cases and up to 1.2 million deaths related to mother-to-child transmission over the next 15 years. For hepatitis C, drug manufacturers have long worked with international organisations and national governments to make therapies available for those who need them the most through partnerships such as Medicines Patent Pool (MPP). Through their agreements innovative licencing agreement with pharmaceutical companies, MPP has delivered hepatitis C and HIV medicines to over 70 million patients in 148 low- and middle-income countries so far.

In some countries with particularly high burdens, public-private partnerships have played a crucial role in the success of national elimination programmes. Strong political will and an openness to partner with both industry and the patient community have underpinned Georgia’s success in tackling hepatitis C and have transformed it from a country with one of the highest prevalence of the virus to one of the few countries on track to eliminate hepatitis C, all in under a decade. Georgia is not alone, as other governments that have embraced collaboration with the private sector, such as Egypt, Mongolia, Iceland and the UK, make up some of the only countries on track to achieve elimination.

Focus on testing

Considering that 95% of people living with hepatitis are not aware they have it, collaboration on scaling up testing and diagnostics is a prerequisite to achieving elimination. Clinton Health Access Initiative (CHAI) and partners worked with community and industry partners in Cambodia, India, Indonesia, Myanmar, Nigeria, Rwanda and Vietnam to implement holistic hepatitis elimination programmes with a strong focus on simplifying diagnostic guidelines and improving access to diagnostics through direct engagement with manufacturers. Their efforts resulted in over two million people screened and 120,000 people cured of hepatitis C in the first four years of the programme.

One Life One Liver

World Hepatitis Day serves as a critical reminder of the global health challenge posed by viral hepatitis and the urgent need for concerted action. Public-private partnerships have proven instrumental in the fight against viral hepatitis, demonstrating the power of collective action. With less than a decade remaining to achieve the UN sustainable development goals on hepatitis, the time for united action is now.

Policymakers need to adopt actionable hepatitis elimination plans that align the efforts of national governments, international organisations, affected communities and industry in order to save over a million lives every year and protect future generations from the impact of viral hepatitis.

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