The Ministry of Public Health (MOPH) of Thailand, the National Health Security Office (NHSO) of Thailand, the Faculty of Medicine Siriraj Hospital, Mahidol University, the Thai Association for the Study of the Liver Disease (THASL), and the non-profit research organization Drugs for Neglected Diseases initiative (DNDi) have combined forces to tackle hepatitis C.
This public-health-focused collaboration, within the framework of Thailand’s National Strategic Plan on Viral Hepatitis, aims to contribute to the goal of eliminating hepatitis C (HCV) as a public health problem in Thailand by addressing persistent barriers in access to life-saving treatments and diagnostics.
HCV is known as a ‘silent killer’ because 80% of people living with the disease remain asymptomatic for years, before developing complications that can include liver disease, cirrhosis, and cancer. Although an estimated 300,000 people die from HCV every year, only a small fraction of people with the disease receive treatment. In recent years, the price of direct-acting antiviral (DAA) treatments have fallen, but not enough for countries to enable wide-scale roll-out of treatment or implement national test-and-treat strategies that could accelerate efforts to eliminate HCV as a public health problem. Early diagnosis and initiation of treatment is crucial towards preventing health problems as a result from infection and also to avoid transmission of the virus.
In the South-East Asia and Western Pacific regions, an estimated 20 million people are chronically infected with HCV. Rapid scale-up of diagnosis and treatment is vital to reducing the burden of disease, which is not decreasing globally despite the fact that simple, safe, and effective treatments have existed for nearly a decade. In Thailand, an estimated 378,000 people living with hepatitis C as of 2020, amounting to 0.5% of the population aged between 15 and 64.
‘My hope is we can achieve elimination by 2030. This partnership statement is testament to our country taking bold steps towards a patient-focused approach for hepatitis C patients. Having access to more choices of DAAs is key in Thailand’s journey towards eliminating hepatitis C by 2030. We need a strong public health approach to ensure more DAAs, including ravidasvir, are available in Thailand so that treatment is affordable for our national programme to treat more patients with hepatitis C,’ said Prof. Dr Prasit Watanapa, Dean of Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
Thailand has a long history of efforts to tackle HCV, including a recently concluded a Phase II/III clinical trial to assess the safety, efficacy, tolerability, pharmacokinetics, and acceptability of 12- and 24-week regimens combining the DAAs, ravidasvir and sofosbuvir, which together form an affordable HCV treatment, first registered in Malaysia in 2021. The clinical trial was co-sponsored by the Ministry of Public Health of Thailand and implemented with strong support from numerous Thai partners, with the aim of bringing this new treatment regimen to the people of Thailand.
The new collaboration will work toward implementing a test-and-treat strategy for HCV in Thailand by rolling out accessible, all-oral treatment at an affordable price and scaling up community-based screening campaigns to find undiagnosed people with HCV. The partnership will also work to improve public awareness of HCV infection risks. All partners are committed to removing the barriers that prevent access to HCV diagnostics and treatments and hinder progress toward reaching the World Health Organization goal of eliminating hepatitis C by 2030.
‘Integrated strategies are important to strengthen the primary healthcare facilities with the support of a patient-focused and community-driven approach. This is very important’, said Prof. Dr Prasit Watanapa, Dean of Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
‘We strongly support and develop cooperation with network partners in the surveillance, prevention and control of diseases, as well as the delivery of appropriate care to those infected with hepatitis. Our goal is to end hepatitis by 2030, improve access to medicines – screening – treatment’, said Dr Opart Karnkawinpong, Director-General, Department of Disease Control (DDC), Ministry of Public Health (MOPH), Thailand.
‘The National Health Security Office (NHSO) support the nations effort towards eliminating hepatitis C by 2030. HCV is one of the rare viral infections that can be eliminated via effective treatments. We will continue to support the hepatitis C patients in encouraging easy access to diagnostics and treatment that they need under the Universal Coverage Scheme (UCS) in Thailand’, said Dr Jadej Thammatacharee, Secretary-General, National Health Security Office (NHSO), Thailand.
‘HCV elimination is possible with rapid scale‐up of prevention, screening and treatment programmes. Initiatives that encourage simplification of hepatitis C testing and treatment in Thailand are welcomed’, said Prof. Pisit Tangkijvanich, M.D., President, Thai Association for the Study of the Liver (THASL), Thailand.
‘Hepatologists have key roles in expanding access to HCV care by supporting our non-specialists/primary care colleagues to embark on test and treat strategies in managing hepatitis C’, said Prof. Pisit Tangkijvanich, M.D., Thai Association for the Study of the Liver (THASL), Thailand.
‘This partnership will address the access barriers that exist in Thailand for hepatitis C treatment and ultimately help to bring more treatment options to Thai patients. To reach WHO 2030 elimination targets, Thailand must scale-up and diversify the supply of affordable DAAs’, said Jean-Michel Piedagnel, South-East Asia Regional Director, DNDi.
‘We will never achieve the 2030 hepatitis C elimination goal without political will, partnerships, and collaborations such as the one in Thailand on access to HCV treatment and therapeutics. It is important for us to work together to ensure that no patients are left behind by addressing the issue of access to medicines for hepatitis C’, said Dr Bernard Pecoul, Founder & Executive Director, DNDi.
The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit R&D organization working to deliver new treatments for neglected patients, in particular for sleeping sickness, Chagas disease, leishmaniasis, river blindness, mycetoma, HIV, hepatitis C, and dengue. DNDi’s ambition is to help enable widespread access to HCV treatment through the development and registration of affordable, safe, and efficacious pan-genotypic direct-acting antivirals (DAAs), and through advocacy for the policy change and political will needed to remove barriers to access to DAAs globally. dndi.org
Thai Association for the Study of the Liver (THASL) is Thailand’s leading professional association with the main objectives in developing and disseminating knowledge and advancement in the field of liver diseases to doctors and healthcare professionals while ensuring the standard of treatment on par with international standards. THASL has regularly organized trainings and encourage local academics, doctors and healthcare professionals to advance in research relating to liver diseases. Moreover, the association has also worked closely to support Liver Foundation of Thailand in communicating accurate information for better understanding about liver diseases to general public. thasl.org
About National Health Security Office (NHSO), Thailand
The National Health Security Office (NHSO), Thailand, established in 2002, was set up as a public organisation that responds to the management system that is efficient and knowledge-based for the public good. It also strives to be part of developing the nation’s sustainability in orientation of public benefits as its ultimate goal. Our responsibility is to create good health security for everyone, whereby – “Everyone who lives in Thailand is covered by the Universal Health Coverage (UHC). This helps to ensure that they have access to healthcare with confidence when needed”. The National Health Security Office (NHSO), Thailand is responsible for the development of a desirable health care service system, covered by the UHC, which are easily accessible via an effective communication and information system. This will help the NHSO to continuously improve its work on an evidence-based system for health care delivery and enabling the beneficiary registration facility, according to their convenience, necessity, monitoring and evaluation system. nhso.go.th
About Ministry of Public Health (MOPH), Department of Disease Control (DDC), Thailand
About Faculty of Medicine Siriraj Hospital, Mahidol University
Faculty of Medicine Siriraj Hospital, Mahidol University, is Thailand’s first public hospital and top medical school. Since its conception, its missions have always been to provide the best healthcare service, produce quality graduates, clinicians, and medical researchers, and conduct high-impact research with implications to medical practice. This revere medical institution with high-experienced expert faculties in various specialties provides exceptional quality and up-to-date medical services with international standards. Located in Bangkok, the capital of Thailand, Siriraj is currently the largest referral center of the country. Over the years, Siriraj has gained trust among Thai people with the mission in providing good health and better quality of life for everyone. si.mahidol.ac.th
DNDi South-East Asia
DNDi Geneva office
Photo credit: Kitjapat Natthapisut-DNDi