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The Nobel Prize for discovery of HCV is a call to end hepatitis
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John W Ward
Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, GA 30030, USA
The Lancet October 29, 2020
This year, Michael Houghton, Harvey Alter, and Charles Rice were awarded the Nobel Prize in Physiology or Medicine for their discovery of the hepatitis C virus (HCV).
Equally important to recognising the rigorous methods employed by these scientists, the Nobel committee also credited this discovery with later development of diagnostic tests and curative treatments. Science is not an end but a means to achieve a greater purpose. The Nobel committee issued a challenge, "For the first time in history, the disease can now be cured, raising hopes of eradicating Hepatitis C virus from the world population". I, together with my colleagues in the Coalition for Global Hepatitis Elimination, agree.
The discovery of HCV placed the world on the path to elimination. Within a few years, reliable tests were available to screen donated blood, reducing the risk of HCV from one in every 14 units to one in every million. Over the following decades, with improvements in blood safety and infection control, new HCV infections declined an extraordinary 90%.
71 million people globally are already living with HCV. Deaths among those infected have sadly mounted to over 500 000 annually.
To curb this epidemic, a safe and effective therapy was needed. In 2014, years of research culminated in the first cure for a chronic viral infection. Anyone infected with HCV are now recommended to receive treatment, saving lives and health-care costs.
Generic HCV therapies are available in more than 100 countries, costing US$200 or less. With these tools, simple care models were developed, and early moving governments in Egypt, Georgia, Rwanda, and Punjab state, India, showed how to scale up HCV testing and treatment within health systems. The recent investments in diagnostic capacity for COVID-19 further increase the feasibility of large-scale HCV testing, treatment, and elimination.
In 2016, WHO set goals for the elimination of HCV by 2030.
However, in 2020, only one in five people infected with HCV are diagnosed, and a smaller fraction is treated and cured.
The barrier to sufficient HCV testing and treatment is no longer on the scientific or public health side. In fact, all the pieces are in place to eliminate HCV, save one: financing.
In the coming decade, 1·5 million deaths can be averted by HCV elimination. Yet major philanthropic funders have not committed to this global goal. Not one. Most international support for hepatitis elimination comes from public-private partnerships with industry. Investments from global partners can catalyse development and evaluation of national programmes. HCV is curable. As shown in Egypt and Georgia, relatively modest external support can jumpstart larger domestic investments in hepatitis elimination. Many countries have plans for HCV prevention, testing, and treatment, and with catalytic investments they can begin to advance towards HCV elimination.
This year's Nobel Prize is a challenge to the philanthropic community. Finish the journey started by these Nobel Laureates. Rally around this Nobel Prize. Commit the financial resources and eliminate hepatitis C.
I declare resources for partial support to the Coalition for Global Hepatitis Elimination of the Task Force for Global Health from governmental and non-governmental organisations and from individual and industry partners, including Abbott Laboratories, AbbVie, Cepheid, Gilead Sciences, Merck, Pharco, Roche, Siemens, and Zydus-Cadila

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