Birx, Farmer: Global AIDS lessons can inform, equip hepatitis response

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Deborah Birx at White House Hepatitis Day commemoration Wednesday

WASHINGTON, DC — Health leaders who gathered Wednesday at the White House to commemorate World Hepatitis Day agreed that recognition of the needless toll and continuing threat of that global, infectious and often deadly disease has been a long time coming. They also cited practical promise in the recent World Health Assembly Hepatitis Resolution that committed the World Health Organization to supporting efforts to build needle exchange and opioid substitution provision into national hepatitis programs, that called on member states to ensure that all people who inject drugs have access to HIV prevention, treatment and support services, and that called for legal and policy measures to make effective new drugs accessible to all who need them. Overall, the resolution called for coordinated strategies to tackle the disease that include local organizations and members of the populations most affected, and that strengthen prevention measures through health systems. The challenge of all of that is appropriate to the need, those who spoke Wednesday, from U.S. as well as international programs, said. And the need, Global AIDS Coordinator Ambassador Deborah Birx noted, is urgent. Deaths from hepatitis B and hepatitis C will soon exceed HIV-related deaths, she said, and at the same time, the viruses will take their greatest toll among people living with HIV, with an estimated third of all people living with HIV co-infected with hepatitis B or C, with HIV accelerating the impact of the viruses.

It is a good thing, Birx added, that 10 years of the President’s Emergency Plan for AIDS Relief provided a path of lessons as well as measures, finally, to reach people at greatest risk with least access  to services. She pointed to implementation science grants, and funding for projects to reach those known as “key populations” that include people who inject drugs, announced by former Secretary of State Hillary Clinton in 2012, and to PEPFAR’s support of safe blood donation and lab safety. She also pointed to  “pillars of PEPFAR” — the program’s evolved emphasis on “impact, efficiency, sustainability, partnership, and human rights.” And she pointed to PEPFAR’s successes: the number of people with HIV receiving the antiretroviral medicine they need tripled in 10 years, a million infants born without HIV to HIV-infected mothers, almost 60 million people who have been tested for HIV. “All because of leadership,” she said, crediting bipartisan congressional support, as well as White House support for the program.

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Paul Farmer

Partners in Health co-founder Dr. Paul Farmer, who followed Birx, agreed, to the extent, he said, that she had delivered most of what he planned to say. But, while the local partnerships that PIH is built on, and the partnerships with countries that PEPFAR is building now are critical, he added, “You still need staff, and stuff and systems. For that you need funding.”

The “stuff,” is medications for hepatitis that systems built and strengthened by PEPFAR can deliver, but the stuff will have to be paid for, he said.

“Of course we can do this with hepatitis,” Farmer said. “PEPFAR was the midwife to global health equity.”

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