Earlier this year, the World Health Organization (WHO) drafted a global strategy for combating viral hepatitis. The strategy addresses all five hepatitis viruses but it’s paying particular attention to the B and C strains due to their comparatively high public health burdens. Approximately 360 million have chronic hepatitis B and C combined, with most of those infected living in sub-Saharan Africa, east Asia, and north and west Africa. Nearly a million people die a year from these infections.
For some years now, global health organizations have been getting the word out about the hepatitis B vaccine. By the end of 2015, the WHO reported that the vaccine had been introduced in 184 countries and global coverage of vaccine administration to newborns stood at nearly 40 percent. Such has not been the case for the hepatitis C virus (HCV).
There is no vaccine for HCV, and in spite of global prevention and awareness campaigns, the number of people living with chronic HCV is growing, even though existing treatment regimens have cure rates of over 90 percent.
For all of the global disease funders out there backing any number of projects combatting diseases like HIV/AIDS, tuberculosis, and malaria, funding to fight HCV is incredibly scarce by comparison. It isn’t completely nonexistent, however. One of the few organizations that’s all-in, here, is the Bristol-Myers Squibb Foundation (BMS Foundation).
The BMS Foundation, the charitable arm of a multinational pharmaceutical company, Bristol-Myers Squibb, recently awarded $1.15 million in grants to combat HCV in sub-Saharan Africa, a region of the world that has one of the highest global burdens of the disease. The grants were split among three NGOs including the TB/HIV Care Association, National Institute for Communicable Disease (NICD), and the Gastroenterology Foundation of South Africa.
The grants are part of the Viral Hepatitis C Initiative. Currently in its early stages, the initiative is being led by the TB/HIV Care Association, which received the lion’s share of the total $1.15 million give with a three-year, $731,000 give from the BMS Foundation in this round. On July 28, which is World Hepatitis Day, the initiative began recruiting participants from seven cities in South Africa. The target populations for this initial recruitment are those that are at high risk of contracting HCV such as people who inject drugs, men who have sex with men, and sex workers.
The Viral Hepatitis C Initiative hopes to reach at least 3,500 patients during the life of the project. While a portion of this work includes prevention, screening and treatment help, a big focus of the project is on research and data collection. By the end, the initiative will produce “the first HCV prevalence data among people who inject drugs, men who have sex with men, and sex workers in South Africa.” The data will determine whether point-of-care testing, the most common method for screening for HCV is effective.
The populations BMS and its grantees are targeting with the Viral Hepatitis C Initiative are also at high risk of contracting HIV, which explains why the grants were awarded out of the BMS Foundation’s Secure the Future Initiative. Also, HIV-HCV co-infections are not uncommon. The Secure the Future Initiative focuses on supporting novel, innovative, and sustainable methods to help young kids, adolescents, and families infected with HIV/AIDS living in sub-Saharan Africa.
Like many infectious diseases, the global HCV burden is disparate. So, too, are the costs of available drug treatments. As the charitable arm of a major drug company, the BMS Foundation may raise more than a few eyebrows. And it’s true, a few years back, BMS (the company) closed on its $2.5 billion bid to purchase Inhibitex, a small developer of what seemed to be a promising hepatitis C drug. Which, had the clinical trials for Inhibitex been successful, would mean that BMS—again the company—would gain a pretty big chunk of the HCV drug market, which is expected to grow from around $12 billion to over $27 billion by 2021. But those trials failed, and Gilead dominates the hepatitis C drug market. Not surprising. It’s newly approved HCV treatment comes with a nearly $75,000 price tag for a 12-week treatment regimen.
Gilead also has a philanthropic arm that makes hepatitis-related grants, mainly having to do with offering its medications to poor countries at a discount.
But I’m not going to get into the controversy that is big pharma pricing. Nor am I going to get into what could be construed as a conflict of interest regarding the foundations of major pharmaceutical companies getting into the disease treatment business. Because that isn’t the point of our look at the BMS Foundation’s HCV funding. The point is, a very small number of funders are paying attention to hepatitis, which is curious for a disease that inflicts such widespread suffering.