DURBAN, South Africa – Today’s plenary session today saw a new 90-90-90 goal set in a talk on tuberculosis and viral hepatitis today: $90 for HIV treatment, $90 for hepatitis B treatment and $90 for hepatitis C cure.
Dr.Anton Pozniak, the director of HIV services at Chelsea and Westminster Hospital NHS Trust in London, issued the challenge. The hepatitis B treatment Entecavir, for example, costs $15,000 a year in the United States, he noted, while research by his London-based group found that a generic version of this medication could be produced and garner a profit for the generic company at a cost of $3 per patient per year. Hepatitis C curative treatment priced at $84,000 in the U.S is available in India for $324, but Dr. Pozniak believes that can be even cheaper.
Calling for elimination of tuberculosis as well as of hepatitis B and C through optimization of current available clinical tools, direct involvement of affected communities, and pursuit of universal health care and social protection, Dr. Pozniak outlined what he called the “long game” at today’s plenary session.
Noting that 95 percent of all tuberculosis cases and 98 percent of deaths from a disease that is curable occur in developing countries, Dr. Pozniak said new tools in the form of shorter and more effective drug treatments and a vaccine will be available by 2025. In the meantime, he argued that widespread use of current preventative therapy, TB treatment and antiretroviral therapy could make a huge impact on the toll of tuberculosis today. Looking forward to the development of a new vaccine, he pointed out that a vaccine that was just 60 percent effective delivered to 20 percent of adults and adolescents could avert 30-50 million cases of TB over a ten year period.
Highlighting viral hepatitis, now one of the top 10 leading causes of death worldwide, he called for efforts to ensure all infants in affected countries get vaccinated for hepatitis B, the cause of half of all cases of liver cancer. Four million people with HIV also have hepatitis B, Dr. Pozniak said.
There must be more testing to identify the 185 million people with hepatitis C, only 15 percent who know they have it, he noted, to reach the World Health Organization’s goal to provide 80 percent of people living with this virus with curative therapy by 2030. He also called for all countries to adopt the model of Portugal, and to provide the cure to all people living with hepatitis C regardless of liver status. Many countries where hepatitis C treatment is available, limit its access to those with severe liver disease.
Dr. Pozniak asked for concerted action with a “focus on data and results”, strong advocacy for price reductions and integrated care of all of these infections, including HIV.