FIND is the lead partner on a multi-year, multi-country HCV project funded by Unitaid. The distinct aims of each country project are described in the overviews below.
Cameroon has a relatively high HCV burden, with an estimated national prevalence of 1.03%, rising to more than 7% among people over 55 years of age. However the country is just in the process of developing a national hepatitis C strategy and an HCV diagnostic algorithm, and there is low community awareness about HCV.
As part of a multi-year, multi-country HCV project funded by Unitaid, FIND is working with the Cameroon Ministry of Public Health, including the Department of Disease Control, Epidemics and Pandemics (DDCEP), the Centre Pasteur du Cameroun (CPC), the Cameroonian Society of Gastroenterology, and the Elisabeth Glaser Pediatric AIDS Foundation (EGPAF) to expand access to quality HCV care in Cameroon.
Project activities include:
- Promoting innovative diagnostic strategies
- Developing affordable proficiency testing panels for low-resource settings
- Supporting demonstration projects for HCV testing and care
- Supporting novel approaches for screening at-risk populations
- Informing the development and implementation of a national HCV strategy
FIND’s approach in Cameroon incorporates screening and confirmatory testing within HIV testing and treatment centres. It will introduce one-step sampling strategies to reduce cost, complexity and time to diagnosis. The results of the demonstration projects will be shared with the Ministry of Health, and reviewed and translated into cost-effective, scalable models that optimize proven strategies.
In Georgia, the national HCV seroprevalence is an estimated 7.7%, with a prevalence of active disease at 5.4%. Approximately 3.9% of people who are infected with HIV are also co-infected with HCV. Despite early successes with Georgia’s pioneering HCV elimination programme, a 2015 national HCV seroprevalence survey suggested that fewer than 40% of those living with HCV were aware of their status.
As part of a multi-year, multi-country HCV project funded by Unitaid, FIND is partnering with the National Centre for Disease Control, which leads the national response to HCV in close collaboration with the Ministry of Health, the National AIDS Centre, the U.S. Centers for Disease Control and Prevention, the Global Fund-supported Georgian Harm Reduction Network and civil society partners.
The primary purpose of the project in Georgia is to prove the effectiveness of decentralizing HCV testing capacity to maximize programme reach and impact by improving linkages to care and reducing costs. Connectivity solutions will help reduce loss to follow-up, ensure stock management and strengthen disease surveillance. Ultimately, these strategies could provide a scalable model for other countries.
An estimated 7.5 million people in India are living with HCV infection. Approximately 13% of the 2.1 million people living with HIV are co-infected with HCV.
FIND plans to introduce innovative testing strategies to reduce cost, complexity and time to diagnosis, as well as reduce the loss to follow-up of patients after screening and diagnosis. Connectivity solutions will help to reduce loss to follow-up, while ensuring stock management and surveillance for demonstration sites. FIND will empower local stakeholders by launching an “Innovation Incubator” for new ideas to increase demand for HCV screening among target populations.
In the states of Punjab, Uttar Pradesh, Manipur and Delhi, FIND is working with state governments and partners to expand affordable HCV services for hard-to-reach patients, including people with HCV/HCV co-infections and intravenous drug users. The results of these state-specific projects will inform national HCV policy and, it is hoped, support the introduction of scalable models of HCV care in other states.
The HCV prevalence in Malaysia is estimated at 2.5% nationwide, with people who inject drugs accounting for about 59% of people living with HCV.
FIND is partnering with the Drugs for Neglected Diseases initiative (DNDi) in their clinical trial sites to expand access to quality HCV care. FIND will support DNDi by performing decentralized screening of patients and directing patients to confirmatory testing and treatment through the DNDi trial.
FIND will explore the possibility of using a novel one-step sampling strategy, which will allow screening and confirmatory testing from the same sample on dried blood spots. Additional samples from the DNDi trial will be used to develop quality assurance and proficiency testing schemes, with the development of panels and a sample repository.
FIND will also empower local stakeholders by launching an “Innovation Incubator” for new ideas to increase demand for HCV screening among target populations. In order to guide the development and implementation of a national HCV policy, FIND will provide the Ministry of Health with data to scale up cost-effective screening of patients who are at high risk of HIV/HCV co-infection.
The national HCV seroprevalence in Myanmar is an estimated 2.7%, with 678,484 cases in 2015. Approximately 3.9% of people who are infected with HIV are also infected with HCV. While Myanmar launched its National Hepatitis Programme in 2014, it is just starting to provide HCV diagnosis and treatment.
As part of a multi-year, multi-country HCV project funded by Unitaid, FIND is working closely with Myanmar’s National Hepatitis Programme, National Health Laboratory, Myanmar Liver Foundation, Clinton Health Access Initiative, National AIDS Programme, WHO Myanmar, Burnet Institute and other partners to address the immediate diagnostic gaps in the national HCV plan.
FIND will explore the possibility of introducing one-step testing strategies in Myanmar to reduce cost, complexity, time to diagnosis, and loss to follow-up. HCV screening and decentralized confirmatory testing will be introduced in drug treatment centres to reach at-risk patients in areas of high HIV/HCV co-infection. FIND will work closely with the government to support the further development of a cost-effective and efficient national hepatitis programme in Myanmar.
Viet Nam has a significant HCV burden, with an estimated 1.8 million cases in 2016 and a national prevalence of 1.92%. There are large gaps in access to diagnostics and treatment for key populations, especially people who inject drugs and those co-infected with HIV and HCV. There are currently no official HCV testing guidelines within the healthcare system, and there is a lack of available data on current HCV care in the public sector to inform decision-making.
FIND’s multi-year, multi-country HCV project funded by Unitaid will implement demonstration projects that generate evidence on a decentralized model of HCV care in Viet Nam. FIND will explore the possibility of implementing a novel one-step testing strategy in Viet Nam to reduce cost, complexity and time to diagnosis, as well as lower the loss to follow-up of patients after screening and diagnosis. Connectivity solutions will help reduce loss to follow-up, while ensuring stock management and surveillance for demonstration sites.
FIND’s partners include the Ministry of Health, the National Hospital for Tropical Diseases, WHO Viet Nam, the Clinton Health Access Initiative (CHAI), Médecins du Monde, the U.S. Centers for Disease Control & Prevention, USAID, and others.