On June 20, 2013, I had the honor of attending a roundtable hosted by the Georgian government’s Ministry of Corrections and Legal Assistance to officially announce its hepatitis C treatment project in prisons. To my astonishment and joy, the Ministry of Health also announced that it would launch a program for the general population and reach universal coverage by 2016.
Why is this important? Well, for over two years, we have worked in Georgia with remarkable treatment access advocates pushing to secure political commitment to address the country’s hepatitis C epidemic. This announcement represents everything we had collectively been working to achieve, and while revolutionary for Georgia, carries significant international implications as well.
Specifically, there are three critical lessons that other countries can learn from Georgia’s experience:
There needs to be demand for access to hepatitis C treatment.
There needs to be political commitment to treat patients.
The price of treatment must be reduced.
The vast majority of the estimated 185 million people living with hepatitis C worldwide reside in lower- and middle-income countries like Georgia, where there is virtually no access to treatment and no government response. Much of this has to do with the fact that hepatitis C is a hidden epidemic: Most people don’t know they’re infected as a result of lack of access to both diagnostics and treatment.
For two years, Georgian advocates have been raising the profile of hepatitis C in the country through mass events, protests, and campaigns, and have mobilized thousands of patient voices to demand action by their government. Hepatitis C simply became a problem that the government could no longer ignore.
A major reason the government felt powerless to respond was the exorbitant price of Pegylated-Interferon; the backbone medicine of hepatitis C treatment, produced and patent-protected by the pharmaceutical giants Roche and Merck. At roughly $18,000 for a 48-week course, treatment is currently inaccessible for patients who have to pay for it out of pocket, and unaffordable for the government.
We know this doesn’t have to be the case, and have documented prices for the same medicines at a fraction of the cost. For example, the Egyptian government procures these medicines for less than $2,000 for a 48-week course. Now, backed by Georgian civil society and patient groups putting pressure on Roche and Merck to reduce their prices, the Georgian government will fiercely negotiate with these companies to reach a price that will ensure their goal of universal coverage can be reached.
The price Georgia secures will not only represent a victory for the country, but for the global access to hepatitis C treatment movement—a movement consisting of patients and their advocates fighting to gain access to these lifesaving medicines, and urging governments and pharmaceutical companies to put lives before profit.
Echoing many others in this movement, we applaud and stand in solidarity with the Georgian government—one of the first lower- and middle-income countries to take a lead in the global fight against hepatitis C.