• DNDi_Logo_No-Tagline_Full Colour
  • Our work
    • Diseases
      • Sleeping sickness
      • Visceral leishmaniasis
      • Cutaneous leishmaniasis
      • Chagas disease
      • Filaria: river blindness
      • Mycetoma
      • Paediatric HIV
      • Cryptococcal meningitis
      • Hepatitis C
      • Dengue
      • Pandemic preparedness
      • Antimicrobial resistance
    • Research & development
      • R&D portfolio & list of projects
      • Drug discovery
      • Translational research
      • Clinical trials
      • Registration & access
      • Treatments delivered
    • Advocacy
      • Open and collaborative R&D
      • Transparency of R&D costs
      • Pro-access policies and IP
      • Children’s health
      • Gender equity
      • Climate change
      • AI and new technologies
  • Networks & partners
    • Partnerships
      • Our partners
      • Partnering with us
    • Global networks
      • Chagas Platform
      • Dengue Alliance
      • HAT Platform
      • LEAP Platform
      • redeLEISH Network
    • DNDi worldwide
      • DNDi Switzerland
      • DNDi DRC
      • DNDi Eastern Africa
      • DNDi Japan
      • DNDi Latin America
      • DNDi North America
      • DNDi South Asia
      • DNDi South-East Asia
  • News & resources
    • News & stories
      • News
      • Stories
      • Statements
      • Viewpoints
      • Social media
      • eNews Newsletter
    • Press
      • Press releases
      • In the media
      • Podcasts, radio & TV
      • Media workshops
    • Resources
      • Scientific articles
      • Our publications
      • Videos
    • Events
  • About us
    • About
      • Who we are
      • How we work
      • Our strategy
      • Our donors
      • Annual reports
      • Our prizes and awards
      • Our story: 20 years of DNDi
    • Our people
      • Our leadership
      • Our governance
      • Contact us
    • Work with us
      • Working at DNDi
      • Job opportunities
      • Requests for proposal
  • Donate
  • DNDi_Logo_No-Tagline_Full Colour
  • Our work
    • Diseases
      • Sleeping sickness
      • Visceral leishmaniasis
      • Cutaneous leishmaniasis
      • Chagas disease
      • Filaria: river blindness
      • Mycetoma
      • Paediatric HIV
      • Cryptococcal meningitis
      • Hepatitis C
      • Dengue
      • Pandemic preparedness
      • Antimicrobial resistance
    • Research & development
      • R&D portfolio & list of projects
      • Drug discovery
      • Translational research
      • Clinical trials
      • Registration & access
      • Treatments delivered
    • Advocacy
      • Open and collaborative R&D
      • Transparency of R&D costs
      • Pro-access policies and IP
      • Children’s health
      • Gender equity
      • Climate change
      • AI and new technologies
  • Networks & partners
    • Partnerships
      • Our partners
      • Partnering with us
    • Global networks
      • Chagas Platform
      • Dengue Alliance
      • HAT Platform
      • LEAP Platform
      • redeLEISH Network
    • DNDi worldwide
      • DNDi Switzerland
      • DNDi DRC
      • DNDi Eastern Africa
      • DNDi Japan
      • DNDi Latin America
      • DNDi North America
      • DNDi South Asia
      • DNDi South-East Asia
  • News & resources
    • News & stories
      • News
      • Stories
      • Statements
      • Viewpoints
      • Social media
      • eNews Newsletter
    • Press
      • Press releases
      • In the media
      • Podcasts, radio & TV
      • Media workshops
    • Resources
      • Scientific articles
      • Our publications
      • Videos
    • Events
  • About us
    • About
      • Who we are
      • How we work
      • Our strategy
      • Our donors
      • Annual reports
      • Our prizes and awards
      • Our story: 20 years of DNDi
    • Our people
      • Our leadership
      • Our governance
      • Contact us
    • Work with us
      • Working at DNDi
      • Job opportunities
      • Requests for proposal
  • Donate
Home > Viewpoints

What role for DNDi in hepatitis C?

Home > Viewpoints

What role for DNDi in hepatitis C?

Hepatitis C activists at the International Liver Congress 2016
28 Apr 2016

BPecoul_3

Viewpoint by

Bernard Pécoul, Executive Director, DNDi

The barriers to accessing new hepatitis C drugs are a clear illustration of how today’s system of medical innovation is failing to deliver affordable treatments for people in need.

Not that innovation in this field is lagging: with around ten new direct-acting antivirals (DAAs) approved in Europe or the U.S., more than 30 other compounds in clinical development, and over three hundred drug clinical trials underway, drug development for hepatitis C is an extremely exciting field.

DAAs are a real leap forward for patients, offering a radically shortened, highly effective treatment course, with no injections and little side effects. For the first time ever, new DAAs have led many believe that elimination of hepatitis C – which affects up to 150 million people – is now a possibility. But, as been widely reported for the past few years, the vast majority of patients are unable to benefit from these therapeutic breakthroughs.

Hepatitis C activists at the International Liver Congress 2016
Hepatitis C activists at the International Liver Congress 2016

So what should the public health community do to address this complete disconnect between highly successful innovation on the one hand, and unacceptably limited access on the other?

The question of access to medicines and access to medical innovation is up on the political agenda like never before. A special UN High-Level Panel has been created specifically to explore the issue, and the price of medicines could even make it on the agenda of the G7 summit in June.

Hepatitis C medicines, along with drugs to treat cancer, are at the heart of the storm. New treatment regimens combining DAAs cost upwards of $100,000 in the US, and €40,000 in European countries. Health systems in high-income countries are struggling to cope with these expenses, and many are rationing medicines to those most in need.

Middle-income countries such as Brazil, Malaysia and Thailand – home to around 75% of the people living with hepatitis – are worse off still. These patients are largely cut out of the voluntary licensing deals struck by Gilead and Bristol-Myers Squibb with generic manufacturers to lower the price of treatment.

Beyond the question of price, recent drug development in hepatitis C shows how the priorities of medical innovation are skewed away from patients’ needs, and towards areas of greatest commercial reward. Most existing DAAs and the majority of existing R&D efforts target the genotype 1, prevalent in high-income countries, where only 5% of people with HCV live.  They have lower efficacy against other genotypes. As a recent paper released by DNDi argues, research has prioritised genotypes common in these rich markets, and collaborative efforts that could have benefitted patients in poorer markets were shelved.

So what can DNDi do about it?

By focusing on patients’ needs, our ambition is to help foster a public health approach to tackling hepatitis C. Anything else would mean wasting the unprecedented opportunity that DAAs offer: as well as transforming treatment and saving lives, by scaling up treatment we could reduce transmission and stop the disease from spreading. The cornerstone of a public health approach to HCV must be the development of affordable and easy-to-use treatment tools that will, to the greatest extent possible, enable the same regimens to be used for all HCV patients, regardless of genotype, liver disease stage, HIV co-infection, or source of infection.

This objective is at the foundation of DNDi’s new hepatitis C project unveiled earlier this month at the International Liver Conference. Partnerships concluded with the Egyptian pharmaceutical company Pharco and with Presidio, a U.S biotech company, will enable DNDi to test new regimen of sofosbuvir together with ravidasvir, a promising DAA in the development pipeline which has proven effective in genotype 4. We will build on Pharco’s experience in Egypt, a country which has the world’s largest proportion of hepatitis C infected individuals, but has made enormous leaps and bounds in treating these people using affordable DAAs and a public health approach.

Public leadership to improve the standard of hepatitis C care is key, and our project is a strong example of this. The Ministries of Health in Malaysia and Thailand are co-sponsoring clinical trials with DNDi to start shortly in these two countries. Significantly, if the trials are successful, Pharco has agreed to set the commercial price at under $300 per treatment course.  Given the estimated costs of producing most DAAs is low, this price may well fall further, making massive scale-up in affected countries feasible, provided patent barriers can be overcome.

While the close collaboration with two Ministries of Health and with two industry partners builds on our strong history of working with others to deliver tools for neglected diseases, overall the project marks a new direction for DNDi. Having built in the past decade the world’s largest drug development pipeline for the most neglected diseases, hepatitis C was added to DNDi’s portfolio in 2015.  The move came as a part of the adoption of a more flexible, dynamic approach, and in a bid to address the rapidly evolving needs in today’s global health R&D landscape.

Through this new R&D project for HCV, our hope is to deliver a safe, efficacious, affordable, and easy-to-use treatment.  Ultimately, this is about ensuring that today’s neglected populations also get to benefit from the recent progress of science.

Dr Bernard Pécoul, Executive Director, DNDi

Resources:

  • More about Hepatitis C
  • DNDi HCV R&D Strategy
  • Download Hepatitis C Infographic Images
  • Download Hepatitis C Infographic PDF
  • Press Releases
Hepatitis C

Read, watch, share

Loading...
Press releases
13 Jun 2025

Serum Institute of India signs a memorandum of understanding (MoU) with DNDi to advance the development of a new treatment for dengue in low- and middle-income countries

Press releases
13 Jun 2025

K-MEDI and DNDi have initiated collaborative R&D to develop a treatment for neglected diseases

News
6 Jun 2025

DNDi is partnering with Médecins Sans Frontières South Asia for the Without Borders Media Fellowship 2025 

News
5 Jun 2025

Meet the DNDi Eastern Africa 2024-2025 Media Fellows

Press releases
5 Jun 2025

Colombia becomes first country to recommend rapid tests to diagnose Chagas disease

Statements
27 May 2025

DNDi interventions at the 78th World Health Assembly

Press releases
22 May 2025

Six African nations commit to eliminate deadly neglected disease visceral leishmaniasis

Videos
20 May 2025

The Children of the Sierra

VIEW ALL

Help neglected patients

To date, we have delivered thirteen new treatments, saving millions of lives.

Our goal is to deliver 25 new treatments in our first 25 years. You can help us get there. 

GIVE NOW
Linkedin-in Instagram Twitter Facebook-f Youtube
International non-profit developing safe, effective, and affordable treatments for the most neglected patients.

Learn more

  • Diseases
  • Neglected tropical diseases
  • R&D portfolio
  • Policy advocacy

Get in touch

  • Our offices
  • Contact us
  • Integrity Line

Support us

  • Donate
  • Subscribe to eNews

Work with us

  • Join research networks
  • Jobs
  • RFPs
  • Terms of Use   
  •   Acceptable Use Policy   
  •   Privacy Policy   
  •   Cookie Policy   
  •   Our policies   

  • Except for images, films and trademarks which are subject to DNDi’s Terms of Use, content on this site is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 3.0 Switzerland License