Blog

A Stepwise Approach to a National Hepatitis C Screening Strategy in Malaysia to Meet the WHO 2030 Targets: Proposed Strategy, Coverage, and Costs

In April 2019, this article on HCV screening in Malaysia was published in the journal, Value of Health Regional Issues. Authored by Pharos’s
Lindsey Hiebert and colleagues at the University of Malaya and the Netherlands Institute for Public
Health and the Environment, it models an efficient strategy for screening patients in order to reach
Malaysia’s HCV elimination targets.

To develop a screening strategy, we designed and analyzed a step-wise approach where targeted
screening of people who inject drugs (PWID) and others with higher rates of infection would be phased
in over time. Making hepatitis screening as efficient as possible is an important issue for low- and middle-income
countries. Millions of individuals remain un-diagnosed and as HCV drug prices continue to decline, screening costs will become an important cost driver. We believe our Malaysia analysis and tools can assist other countries looking to design similar programs.

The Investment Case for Hepatitis C Elimination – the Example of Morocco

In an article published on January 28, 2019 in the Journal of Global Health Reports, a team from Pharos including President Robert Hecht and Project Manager Lindsey Hiebert, along with partners from the Paris-based Coalition Plus and the Moroccan Association de Lutte Contre le SIDA, present the health and economic benefits arguments in favor of a large-scale investment in eliminating hepatitis C in the Morocco over the coming decade.

The article entitled “Morocco investment case for hepatitis C: using analysis to drive the translation of political commitment to action” suggests that a phased investment of $650 million over the next 12 years could save more than 50,000 lives and prevent 140,000 new infections, especially among the poorest who are currently not eligible for treatment through publicly-mandated health insurance. As the cost of hepatitis drugs and tests continues to fall worldwide, the overall price tag for hepatitis C elimination could even be lower.

Since the Morocco investment case was discussed with the Minister of Health in 2017 and presented formally to the Government last year, Moroccan health leaders have announced their commitment to purchasing Hepatitis C drugs for a first cohort of 6,500 patients on the road to a large-scale national program.

Exploring the Case for Investment in Hepatitis Scale Up in South Africa, February 2018

In an article published in Health Policy and Planning, three Pharos staff and other collaborators from South Africa, Harvard, and Imperial College, and the Center for Disease Analysis present one of the first comprehensive investment cases for hepatitis scale-up in low and middle- income countries. In South Africa, Pharos supported the development of a five-year national strategy for hepatitis B and C, covering activities including hepatitis B birth dose vaccination, prevention of vertical transmission, treatment of hepatitis B, and treatment of hepatitis C with the new generation of highly-effective cures. The investment case synthesizes the expected cost, health impact, cost-effectiveness, and budget impact of this package of interventions. The paper finds that scale up of hepatitis investments could be both affordable and represent good value for money for South Africa, while averting thousands of new infections, deaths, and cases of advanced liver disease

CSIS Commentary: A New Paradigm in Disease Control – the Example of Hepatitis C, July 2016

In this commentary, Pharos President Robert Hecht and CSIS Global Health Policy Center Director Stephen Morrison explore a new and emerging paradigm for development assistance for health, in which middle income countries use domestic funding to pay for drugs, vaccines, health workers, and other inputs to disease control scale up, while donors focus their limited resources on key global public goods – knowledge and technical assistance that can help to shape and accelerate the design and implementation of life-saving interventions such as Hepatitis C treatment.