Over the past several years, there has been a substantial expansion of community engagement on the hepatitis C Virus (HCV). Communities—along with allies in civil society—have played a key role in the acceleration of government responses to HCV. Many of the organizations involved in HCV advocacy have long worked on HIV issues, translating many lessons learned from the fight against AIDS. Such activism provides a blueprint for the international response to HCV.
Significant barriers—such as financing, awareness, complicated and unaffordable diagnostics, centralized service delivery, and stigma—obstruct the sustainable scaling up of prevention, testing, and treatment services. Despite the recent emergence of a cure in 2014, it is estimated that annual new infections continue to outpace the annual number treated.
High prices for direct acting antivirals (DAAs) in high-in-come countries (HICs) have dominated the discourse and made hepatitis C treatment the prime example for a broken drug development system. These high prices have impacted prices in upper middle-income countries, leading to treatment rationing. Such high prices are all-the-more unacceptable when feasible generic prices are taken into account. In less than two years, a 12-week treatment course has become available for less than US$ 150 when procured under robust generic competition.
Yet, as shown in countries with low-cost generics, high prices are not the only bottleneck blocking progress towards HCV elimination.