October 10, 2013
Dr. Philippe Douste-Blazy, Chair, Executive Board
UNITAID
c/o World Health Organization (WHO)
20, avenue Appia
CH-1211, Geneva 27
Switzerland
Dear Dr. Philippe Douste-Blazy and members of the Executive Board,
We commend UNITAID for addressing viral hepatitis in its 2013–2016 Strategic Objectives. We are writing to underscore the need for a swift response from UNITAID to hepatitis C virus (HCV) coinfection; delays will cost lives and impede scale-up when more effective and tolerable therapies are available.
HCV is a prevalent—and deadly—coinfection among people living with HIV/AIDS, especially people who inject drugs (PWID). An estimated 5 million people are HCV-coinfected (although surveillance data in many low- and middle-income countries [LMICs] are limited to nonexistent).[1] HIV increases the risk for, and rate of progression to, liver cirrhosis.[2],[3] End-stage liver disease secondary to HCV coinfection is a leading cause of death among HIV-positive people who have access to antiretroviral therapy.[4],[5] In fact, HCV coinfection increases the risk of all-cause AIDS-related and liver-related mortality.[6]
Hepatitis C is curable (an outcome known as sustained virological response, or SVR), regardless of HIV status. In HIV/HCV-coinfected people—even those with cirrhosis—SVR is associated with improved ART tolerability and decreased liver-related and AIDS-related illness and death.[7],[8],[9],[10]
From experience with HIV, we have learned that it is possible to scale up delivery of lifesaving treatment in LMICs. UNITAID has been instrumental in the continued success of HIV treatment scale-up in LMICs.
Given the upcoming HCV treatment revolution and the inevitable HCV-related death toll among untreated coinfected people in the coming years, we urge UNITAID to promptly provide full support for the two exploratory analyses identified in the 2013–2016 Strategic Objectives:
- Make affordable treatment regimens available for HIV/HCV coinfections
- Consolidate demand, and negotiate prices for key HCV diagnostics
We strongly believe that immediately addressing HCV coinfection will bolster UNITAID’s main priority. Interventions to facilitate access to HCV diagnostics and treatment must commence if we are to optimize HIV treatment outcomes for millions of people. We urge UNITAID to support high-quality proposals that address HIV/HCV coinfection without delay.
Sincerely,
AA Bangladesh, Bangladesh
ABCD Health Services, USA
Aceso International for Women
ACT UP-Paris, France
Action S Impliquer Dans l Amour (S.I.D.A) Comores, Comores
ADHARA, Spain
African Community Advisory Board (AFROCAB)
AGEP’C NGO (ANTIHEPATITIS’C), Kazakhstan
Aid Organization (AO), Bangladesh
AIDS Action Baltimore, USA
AIDS Community Research Initiative of America, U.S.
Aids Fonds, The Netherlands
AIDS Foundation of Chicago, United States
AIDS Project Los Angeles, US
AIDS Services Foundation Orange County, USA
AIDS Treatment Activist Coalition, USA
ALCS (Association de Lutte Contre le Sida), Morocco
All-Russian Union of People Living with HIV/AIDS
amfAR, the Foundation for AIDS Research, United States
Andrey Rylkov Foundation for Health and Social Justice, Moscow, Russia
Anex (Association for Prevention and Harm Reduction Programs Australia)
Asia Catalyst, USA
Asia Pacific Network of People Living with HIV/AIDS (APN+)
Asia Pacific Network of Sex Workers (APNSW)
Asian Network of People Who Use Drugs (ANPUD)
Associação SCARJoV, Angola
Association d’Assistance au DÈveloppement, Cameroon
Association of HIV Affected Women and Their Families DEMETRA, Lithuania
BLOSSOM TRUST, INDIA
Bolivian Network of People Living with HIV/AIDS (REDBOL), Bolivia
BOOM! HEALTH, United States
Boston Health Care for the Homeless Program, US
BUILDING CAPACITIES FOR BETTER HEALTH IN AFRICA, CAMEROON
BURUNDI NETWORKOF RELIGIOUS LEADERS LIVING WITH ORPERSONALLY AFFECTED BY HIV/AIDS, BURUNDI
CADIRE CAMEROON ASSOCIAATION, CAMEROON
Canadian HIV/AIDS Legal Network (CHALN)
Centre for Excellence for Research in AIDS (CERiA) – Malaysia
Chichetekelo Outreach Partners, Zambia
Citizen News Service – CNS, India
COMMUNICATION FOR DEVELOPMENT CENTRE, NIGERIA
Community HIV/AIDS Initiative Group, Kenya
Delhi Network of Positive People (DNP+), India
Dhading Plus, Nepal
East Europe & Central Asia Union of PLWHA
Egyptian Initiative for Personal Rights (EIPR)
ELIMU RESOURCES AND EDUCATIONAL CENTER, KENYA
Emmanuel Hospital Association (EHA), India
Estonian Network of PLWH, Estonia
Eurasian Harm Reduction Network (EHRN), Lithuania
European AIDS Treatment Group, Belgium
FIS (For Impacts In Social Health), Cameroon
Foro Español de Activistas en Tratamientos (FEAT) Spain
Fundación Huésped, Argentina
FUTURE WITHOUT AIDS (FWA) – Odessa
GAT – Grupo Português de Activistas sobre Tratamentos de VIH/SIDA
Georgian Harm Reduction Network (GHRN)
Global Coalition of Women Agaisnt AIDS in Uganda – GCOWAU
The Global Forum on MSM & HIV (MSMGF), USA
The Global Network of People Living with HIV (GNP+), Netherlands
The Global Network of Sex Work Projects (NSWP)
Harm Reduction Coalition, USA
HCMSG-The Hepatitis C Mentor and Support Group,Inc., USA
HCV ADVOCATE, United States
Health for All Association, Yemen
Health GAP (Global Access Project), USA
Hepatitis Education Project, United States
HIV i-Base, London
HIV/AIDS Law Project, USA
HIV/AIDS Patients Support Foindation, Georgia
Housing Works, USA
Independent Consulting Company MChJ “Community of PLHIV,” Uzbekistan
Indonesia AIDS Coalition, Indonesia
Indonesian Red Cross Branch Kapuas, Indonesia
Initiative for Medicines, Access & Knowledge (I-MAK)
Integrated Development in Focus, Ghana
International Centre for Science in Drug Policy
International Community of women living with HIV Eastern Africa, Uganda
International Gay and Lesbian Human Rights Commission, USA
International Network of People Who Use Drugs (INPUD)
International Treatment Preparedness Coalition (ITPC)
International Treatment Preparedness Coalition Latin American and Caribbean, ITPC LATCA
International Treatment Preparedness Coalition Middle East and North Africa, ITPC MENA
International Union Against Tuberculosis and Lung Disease, France
Kirovograd Regional Charity Organization “Open Heart”, Ukraine
Lebanese Association for Early Childhood Development
Legal Development and Democracy PU – Azerbaijan
LIBRE DE VIH, Mexico
Mainline, the Netherlands
MAISHA YOUTH AGAINST AIDS, KENYA
Marvorid, Tajikistan
Men Against AIDS Youth Group, Kenya
Missouri Hepatitis C ALliance, USA
National Association of PLHA in Nepal (NAP+N)
National Coalition of PLHIV in India – (NCPI+), India
National Emergency Management Agency (NEMA) South-South Zonal Office, Nigeria
Network Of Maharashtra by People Living with HIV/AIDS – (NMP+), India
NGO “AGEP’C”(ANTIHEPATITIS’C), Kazakhstan
PeterCares House, US
Phoenix – Georgia
Phoenix PLUS – Russia
PILS (Prevention Information et Lutte contre le Sida), Mauritius
PKNI (Indonesian Drug User Network)
Positive Malaysian Treatment Access & Advocacy Group (MTAAG+)
Positive People Armenian Network
POSITIVE-GENERATION, Cameroon
Professionals For Humanity (PROFOH), Nigeria
Projecte dels NOMS-Hispanosida, Spain
Rainbow TB Forum, INDIA
Red Ribbon Foundation Inc., USA
Rehabilitation and Development Charity Center “Tanaziari,” Georgia
S M L S TRUST, INDIA`
sairam health care charitable trust, India
SASO, Imphal – India
Sewa Development Trust Sindh, Pakistan
Society Association HIV.LV, Republic of Latvia
Solthis, France
Spark of Hope – Ukraine
Tanzania Public Health Initiative, Tanzania
Tanzania Sisi Kwa Sisi Foundation (TSSF), Tanzania
Thai AIDS Treatment Action Group (TTAG), Thailand
The AIDS Support Organisation (TASO) Uganda, Uganda
transbantu association zambia, zambia
Treatment Action Group (TAG), U.S.A.
Treatment Education Network, USA
Urban Health Research Initiative of the BC Centre for Excellence in HIV/AIDS / University of British Columbia, Canada
Viet Nam National Tuberculosis control Program, Viet Nam
Vietnam Network of PLHIV (VNP+)
Voices Of Community Activists & Leaders (VOCAL-NY), USA
Vote For Health campaign
Whittier Rio Hondo AIDS Project, USA
With hope, Ukraine
Women and Harm Reduction International Network (WHRIN)
Women`s Health, HIV and AIDS Southern Africa – Zimbabwe
WOTE YOUTH DEVELOPMENT PROJECTS, KENYA
Yale Global Health Justice Partnership, USA
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