Uzbekistan Hepatitis Elimination Project (UHEP)

Catalytic Funding

UHEP will use catalytic funding to reduce the amount of upfront capital required for an elimination program and will rely on patient payments to cover all program costs including repayment of the initial catalytic investment.

CDAF modeling shows that a national elimination program in Uzbekistan could be paid for with a $27M USD catalytic investment, which would pay for a $522M USD program and would be repaid at the end of the program, yielding a catalytic ratio of 19.3.

Pooled Procurement

UHEP will use of a pooled procurement mechanism (GPRO) to source affordable, quality-assured diagnostics and medicines at prices affordable to LMIC patients.

GPRO is a non-profit procurement agency. It negotiates volume pricing directly with manufacturers to reduce costs. GPRO charges 5% of the total order amount to cover administrative costs. No additional markups are added. GPRO does not use distributors – it ships product directly to the purchasing agency. GPRO requires registration and agreement by the purchasing agency to mark up prices a maximum of 5%.

Negotiated Pricing

CDAF has negotiated the waiving of import duties and taxes for UHEP medicines and diagnostics. We have also signed a formal agreement with a national pharmacy chain (OxyMED) to distribute UHEP medicines with a maximum 5% markup.

Simplified Test & Treat

UHEP will utilize simplified diagnostic algorithms for HBV and HCV to reduce program costs and improve linkage to care.

Task-Sharing

Today in Uzbekistan, all hepatitis patients receive care by liver specialists at the Research Institute of Virology. For UHEP testing will take place at district Polyclinics throughout Tashkent and most patients will be treated by General Practitioners at the Polyclinic. Patients with complications or liver disease will be referred to the RIV specialists.

Motivational Interviews

A Motivational Interview technique used successfully in other treatment-oriented programs has been designed to engage patients immediately following a positive screening test, and though a series of short questions help raise awareness of the risks of hepatitis while driving internal motivation to seek and adhere to treatment.

Electronic Registry

UHEP customized a REDCAP electronic patient registry to collect and manage patient consent and patient medical data, and also to facilitate followup with patients who unlink from care. Portable tablets and laptops have been provided to all nurses and doctors to enable near real-time updates of patient records.