Accessibility of HCV diagnostics and treatment services in Eastern Europe and Central Asia (EECA)

Author: Ludmila Maistat, Natalia Kravchenko, Pavlo Skala

Theme: Epidemiology & Public Health Research Year: 2017

Objectives: Alliance for Public Health in collaboration with 11 NGOs in Eastern Europe and Central Asia (EECA) and Medicines Patent Pool (IP data) have conducted a survey aimed to identify key hurdles in HCV response and provide recommendations to increase access to diagnostics and treatment addressing key stakeholders (drug registration and prices, national HCV guidelines and treatment program coverage) and civil society organizations in EECA countries.
Methods: The survey conducted by Alliance in 11 countries of EECA region. Survey instruments: questionnaire covering country-level HCV epidemiology data, access to HCV testing and diagnostics services for KPs, availability and content of HCV testing and treatment guidelines, government and donor-funded HCV program coverage and CSO activities; the tables to be filled in were included for collections of epidemiology data, testing, care and prevention strategies, drug registration and prices.
Results: Reported anti-HCV prevalence ranged from 1.5% to 7.5% for the general population, 22.7% to 70%-95% for PWID and 18% to 80% for PLHIV. HCV treatment guidelines are available in nine countries (82%). 10 countries (91% of the sample) have registered one or more 2nd generation DAAs for potential interferon-free treatment. State and donor-funded treatment programs covered less than 1% of estimated need.
Conclusions: Access to HCV testing and treatment is very limited in EECA countries. Key barriers: absence or lack of state epidemiologic surveillance, lack of awareness, low testing and treatment demand, exorbitant prices for diagnostics and treatment, late registration of DAAs, low or no access to generics, extremely limited or no access to testing and treatment for key populations (criminalization and prosecution of KPs, discrimination, stigma and self-stigmatization), underfunded national programs, low treatment coverage, obsolete national HCV testing, treatment and care guidelines. In EECA, civil society play one of the key roles in increasing access to HCV testing and treatment. The survey provides conclusions and recommendations for civil society and other stakeholders to overcome the epidemic.

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