High hopes but low pledges for hepatitis conference in Geneva

“It’s more than absurd to invest tens of billions of dollars in domestic and international resources to fight AIDS, tuberculosis, malaria only to see patients die from another easily preventable and treatable disease and frequent co-infection.” That’s how Michel Kazatchkine, former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, set the scene at the first hepatitis pledging conference in Geneva yesterday. Describing a “thundering moral imperative to act,” he said “letting someone die or passing on their infection to their children is unforgivable when the diagnosis and treatment cost less than a dinner for two here in Geneva.” Yet that’s what continues to happen. The Global Hepatitis Resource Mobilization Conference — co-hosted by The Hepatitis Fund, the Clinton Health Access Initiative, or CHAI, Saudi Arabia, and Egypt — kicked off a campaign Wednesday to raise an initial $150 million but very few financial commitments had been made by the end of the day. The Hepatitis Fund said on Twitter that it was encouraged by the “groundswell of support from the community, organizations, governments, and industry.” Viral hepatitis, according to the World Health Organization, is an inflammation of the liver that can be transmitted and presented in different ways, leading to the categorization of five main strains labeled A to E. Hepatitis B and C are among the most common, causing chronic disease, liver cirrhosis, and liver cancer. About 354 million people currently live with hepatitis B or C and each year 1.1 million succumb to the disease. The majority of these deaths take place in low- and middle-income countries. Without a substantial increase in resources for prevention, diagnosis, and treatment, it’s estimated that deaths due to hepatitis will outnumber those of HIV, tuberculosis, and malaria combined by 2040. It’s an avoidable emergency given there are treatments and vaccines available that “are not expensive or difficult to obtain,” Chelsea Clinton, vice chair of the board of directors at CHAI, explained to the room in a video message. The issue thus far is that “they’re just not reaching the people who need them.” According to WHO, an estimated 4.5 million premature deaths could be prevented in low- and middle-income countries by 2030 through vaccination, diagnostic tests, medicines, and education campaigns. The agency’s global hepatitis strategy, adopted in 2022, aims to see new infections drop by 90% and deaths reduced by 65% by 2030. “We have vaccines to prevent the transmission of hepatitis B from mother to child at birth. We can prevent hepatitis C transmission in people with substance use disorders due to unsafe injecting. For those who contract these diseases, we have rapid tests to confirm infection in a matter of minutes and we also have medicines that can control hepatitis B and cure hepatitis C,” Clinton explained. The reason these haven't been more widely accessible to date, said Finn Jarle Rode, executive director of The Hepatitis Fund, is a historical lack of government prioritization preceded by issues with advocacy and awareness that he said the fund — inspired by the Global Fund to Fight AIDS, Tuberculosis and Malaria and formed in 2019 as a grant-making body focused on hepatitis — is working on. Hoping the conference would be “the turning point” in efforts to eliminate hepatitis, Clinton called for political will and financial investments to make the resources more readily available going forward. “Over the past two decades, we’ve of course seen regular pledging conferences around HIV, TB, and malaria conducted by The Global Fund [to Fight AIDS, Tuberculosis and Malaria] and similar rounds on vaccines by Gavi. But it’s a first for hepatitis and one we all believe is long overdue,” said Rode of the day’s event. “Globally, we need between $6 and $7 billion to fight hepatitis annually. It’s ten times more than the investment today.” Of the few financial commitments made on the stage, the Hong Kong-based ZeShan Foundation pledged $2 million on top of the initial seed funding it provided to The Hepatitis Fund, while the Center for Disease Analysis Foundation pledged to match the first $10,000 of donations made by individuals. Attendees were urged to make personal pledges. Kenneth Kabagambe, a hepatitis B patient and founding executive director of the National Organization for People Living with Hepatitis B, believes the reticence from donors comes from a lack of understanding of the disease’s economic impact. Data shows that there is a two to four times return on investment for every dollar spent on eliminating hepatitis. . More details on various pledges are expected to be released in the coming weeks but in the meantime two memorandums of understanding were signed by Viatris, CHAI, Hetero, and The Hepatitis Fund to secure lower-cost hepatitis treatments in low- and middle-income countries with a hepatitis C cure at $60 and annual hepatitis B treatment at $29. This should, according to CHAI, reduce the overall annual investment needed by around $2 billion. “The pricing has gone down immensely,” Rode said. Brazil, Egypt, Rwanda, Georgia, and Mongolia are among the countries actively working toward eliminating viral hepatitis while others such as Cambodia, India, Nigeria, and Vietnam have committed to elimination. Last year, U.S. President Joe Biden also committed $11 million over five years to fighting hepatitis C in his country. “This is a global issue [and] everyone has to come to the rescue of the people who are living with hepatitis globally,” Kabagambe said.