20th International AIDS Conference - Melbourne, Australia


TUBS02 Access to Hepatitis C Testing and Treatment
  Bridging Session
Venue: Melbourne Room 2
Time: 22.07.2014, 14:30 - 16:00
Co-Chairs: Tracy Swan, United States
Sanjay Bhagani, United Kingdom

This session will explore the issues associated with improving access to and uptake of hepatitis C (HCV) testing and treatment among people who inject drugs. The session will address the above issues from a range of key perspectives including community representatives, health care providers, researchers and policy makers involved in HCV prevention, diagnosis and management. As relevant, common issues and ‘lessons learned’ from the HIV testing and treatment access experience will be discussed in relation to HCV including issues relating to HIV/HCV co-infection. Finally, a critical assessment of the relevance and evidence to support treatment as prevention in the context of HCV and the importance of the meaningful engagement of the key affected community in bio-medical approaches to addressing HCV will also be discussed.
14:30
TUBS0201
Webcast
Introduction

14:35
TUBS0202
Powerpoint
Webcast
"The Condemned”: a success story from the Ukraine?
O. Stefanyshyna, Ukraine

14:45
TUBS0203
The price indeed can be reduced: the fight for affordable HCV treatment goes on!
S. Golovin, Russian Federation

14:55
TUBS0204
Powerpoint
Webcast
"Treatment as Prevention" for HCV prevention: could this work?
G. Dore, Australia

15:05
TUBS0205
Powerpoint
Webcast
Community perspective on access to HCV prevention and treatment services
E. Agustian, Indonesia

15:15
TUBS0206
Powerpoint
Webcast
Scaling-up screening, diagnostic and treatments for HCV using the HIV programs
I. Meyer-Andrieux, Switzerland

15:25
TUBS0207
Webcast
Moderated discussion

15:45
TUBS0208
Webcast
Question and answers

15:55
TUBS0209
Webcast
Closing remarks

Powerpoints presentations
"The Condemned”: a success story from the Ukraine? - Olha Stefanyshyna
"The Condemned”: a success story from the Ukraine? - Olha Stefanyshyna

"Treatment as Prevention" for HCV prevention: could this work? - Gregory Dore

Community perspective on access to HCV prevention and treatment services - Edo Agustian

Scaling-up screening, diagnostic and treatments for HCV using the HIV programs - Isabelle Meyer-Andrieux



Rapporteur report

Track B report by Mark Bloch


Olga Stephanyshyna spoke of “Patients of Ukraine” a patient-based activist organisation. Ukraine has 3.5 millions with hepatitis C (HCV).  After 5 years of no results, a creative media and street action resulted in wide media coverage and a government sponsored treatment program.

Sergey Golovin representing ITPCru in Russia which engages in media and actions to highlight the 3-7 million people with HCV, mostly IDU (stigmatised) and the main barrier being high cost of treatment.  Access to care is problematic.  He concluded that drivers of price reduction are generics and Govt intervention rather than Pharma goodwill.

Prof Greg Dore questioned: Treatment as prevention – could it work? 
He highlighted eradication (not possible)  vs elimination (feasible)  – the latter meaning  reduction of incidence to zero in specific geographical area or population
Three cities with differing HCV prevalence in IDUs were examined: Edinburgh 25%, Melbourne 50%, Vancouver 65% - in all cities HCV treatment rates per annum were low (<1%)
Modelling of scale up of treatment to 8%, reduction of HCV prevalence to very low (<10%) could be achieved in Edinburgh by 2021, Melbourne by 2027, and Vancouver, several years later. However, globally all countries currently have treatment uptake <8%.
The ideal drug would cure >90%, with minimal toxicity, being a once daily treatment of short duration (4-6 weeks) with pan-genotypic coverage

Edo Augustian  (PKNI organisation),  described the public health crisis in Indonesia where 77.3% of IDU have HCV. There has been a late and fragmented response in Indonesia – only since 2011 have programs been instituted. Treatment is unaffordable and IDU and alcohol dependency is an exclusion from government national health schemes and thus subsidised HCV treatment
 

Isabelle Andrieux-Meyer from Medicine Sans Frontiers explained the limited

access to screening and treatment in resource limited and middle income countries. Potentially HCV screen or HCV spot are inexpensive diagnostic options and potential game changers. There is a need for point of care HCV viral load and inexpensive fibroscanning. Costs of production of DAAs are much lower than current pricing. The goal should be a global diagnostic –treatment package <500 USD per cure

 

 




   

    The organizers reserve the right to amend the programme.