BRAZIL
Situation
In partnership with the Ministry of Health (MOH), new data released by the Center for Disease Analysis Foundation (CDAF) and its Polaris Observatory team showed fewer Brazilians infected by hepatitis C (HCV) than previously estimated. Instead of an estimated 1.6 million cases, the data show that the number of people infected in Brazil was closer to 657,000. The MOH quickly realized eliminating the disease is within reach, but more work must be done.
Our Work
- Collaboration with local experts and government ministries
- Finding and accessing the best data to get better knowledge of the HCV prevalence
- Working with stakeholders to explore different possibilities for addressing the infection rate
- Running various scenarios to examine the disease burden and financials of different treatment and screening scenarios
Results
At the World Hepatitis Summit (WHS) in Sao Paolo in November 2017, Brazil announced its sustainable
and financially viable plan to diagnose and treat all citizens infected with hepatitis C and eliminate the disease by
2030.
Read the entire case study here: Brazil Case Study
EGYPT
Situation
Egypt had the highest prevalence of hepatitis C (HCV) in the world. Between the 1950’s and
1980’s, the government waged an aggressive control campaign to eradicate a blood parasite, resulting in
approximately 36 million injections – often administered with unsterile needles – and causing the infection of
millions of Egyptians.
This caused a tremendous disease burden which was compounded by expensive, older therapies that weren’t accessible to large portions of the population. A diagnosis of liver cancer or cirrhosis of the liver was often fatal in Egypt.
Our Work
- Conducted an economic analysis that accounted for direct and indirect costs of HCV screening and treatment
- Worked with Professor Imam Waked from the National Liver Institute in Egypt to develop strategies to eliminate HCV
Results
Our new plan of action began in 2014 with a goal of treating 300,000 patients annually, with cost subsidies for four years. After seeing successes, the plan continued each year. In 2016, 577,000 patients were treated and the plan expanded to include patients at all stages of disease, even those without any HCV-related consequences yet.
Read the entire case study here: Egypt Case Study
Mongolia
Situation
Although Mongolia has a relatively small population of 3 million residents, it has one of the highest liver cancer mortality rates in the world – six times higher than the global average. Many of those diagnosed have hepatitis C (HCV), making it also one of the countries with the highest rates of hepatitis disease burden. Mongolia is a challenging environment partially because its population is not concentrated in urban areas, with many of those infected live in remote, rural regions without easy access to screening or treatment.
Our Work
- Working with World Health Organization’s Regional Office for the Western Pacific (WPRO) to design an economic analysis and understand the disease burden
- Helping the Mongolian government develop affordable treatment options and screening strategies
- Working with the WPRO to develop a national screening program in urban and rural areas
Results
Around the time of our economic analysis, Mongolia allocated US$9 million to the country’s health insurance in order to subsidize medicine and an additional US$90 million for screenings until 2020. One successful innovation in paying for treatment that CDAF worked with partners to develop – which included WPRO, the president of the Mongolian Association on Study of Liver Diseases (MASLD), Dr. Oidov Baatarkhuu, a physician professor and a group of other researchers – was the copayment method based on income level. The Mongolian government subsidized part of drug treatment and as prices declined, treatment became even less expensive for patients.
Read the entire case study here: Mongolia Case Study
Cameroon
Situation
Until 2011, the prevalence of HCV in Cameroon was believed to be 13 percent – making it one of the highest in the world. Recent studies have set prevalence at slightly more than one percent, but this still corresponds to nearly 200,000 individuals – most of whom are undiagnosed and untreated. There are no national standard screening procedures for HCV and most patients learn about their diagnosis when they first begin having symptoms, which is usually after the disease has progressed.
Unlike other nations where the disease affects populations in all areas of the country, we learned that Cameroon’s infected population instead was concentrated in regional areas, particularly in the eastern and southern regions where there is a large population over the age of 50. Access to health insurance is limited in Cameroon, leaving patients seeking treatment to pay out of pocket – something that is difficult for a country with high poverty rates. There is currently a government-subsidized system in place, designed to facilitate access to treatment through a specially created fund.
Our Work
- Collaborating with The Pasteur Institute in Cameroon to build a disease burden model
- Assessing the costs and possible structure of an expanded national HCV treatment program
Results
After completing disease burden quantification in 2016 and publishing results in 2017, CDAF will spend the first six months of 2018 providing modeling and other data analytics support to the investigation into the costs and possible structure of an expanded national HCV treatment program.
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