HEAD-Start

What is this project?

The Hepatitis C Elimination through Access to Diagnostics (HEAD-Start) project is working to improve diagnosis of hepatitis C virus (HCV) by making it more affordable and more widely available to those in need, with a focus on serving people co-infected with HIV.

Why are we working on it?

R&D of HCV diagnostics has not kept pace with drug development. Very few tools currently available for HCV screening and diagnosis are affordable or appropriate for use at the point of care in low-resource settings. Moreover, these tools are of limited use in certain populations, especially for patients who are co-infected with HIV.

One of the challenges for managing HCV and HIV coinfections are the siloed approaches to disease management that prevail in many low- and middle-income countries. Integration of HCV and HIV services would give potential patients the opportunity to be tested and treated for both infections in one place – increasing the likelihood of identifying coinfection, and easing the time and cost burdens that patients face when services are not offered together.

What does it involve?

The HEAD-Start project has four components designed to overcome the major obstacles that impede scale-up of HCV testing and thereby prevent patients from accessing care.

• Catalysing diagnostic R&D to expand the number of tools for HCV screening and confirmation, and for sample collection and transport, that are ready for purchase or use in countries. The focus is on point-of-care tools and platform technologies that can facilitate an integrated approach to diagnosis of HCV.
• Conducting demonstration projects that integrate HCV testing into HIV programmes, to generate evidence that will help to prepare the market for the introduction, use and placement of the new tools in four high-burden countries (Georgia, India, Myanmar, Malaysia). The aim is to bring testing closer to where patients first seek care (decentralization) and better address coinfection.
• Ensuring affordability of HCV diagnostics, by negotiating prices with manufacturers, developing a global market analysis on HCV diagnostics, and investigating the cost-effectiveness of different testing pathways.
• Delivering evidence to support global, regional and national policy change, as well as informing the development of WHO guidelines for implementation and scale-up of HCV testing.

What do we expect to achieve?

HEAD-Start is designed both to develop urgently needed new tools and to build the evidence base that will drive a change in global implementation guidelines and national policies that will support scale up of HCV management in support of the 2030 elimination targets.

Partners and funding

In Georgia, we are collaborating with the Ministry of Labour, Health and Social Affairs, the Georgian National Center for Disease Control and Public Health (NCDC) and the Georgian Harm Reduction Network (GHRN) to implement the project.

In India, our work is supported by the government of Punjab, the government of NCT of Delhi, the Institute of Liver and Biliary Sciences (ILBS) and the YR Gaitonde Centre for AIDS Research and Education (YRG CARE).

In Myanmar, we are working with the Burnet Institute (BI) in partnership with Myanmar Liver Foundation (MLF), as well as providing material support to the National Hepatitis Control Programme to escalate HCV testing and treatment.

In Malaysia, our activities are a collaboration with the Drugs for Neglected Diseases initiative (DNDi). We are working with the Institute for Medical Research (IMR), and also providing technical assistance to the Malaysian Ministry of Health and Clinical Research Malaysia (CRM).

HEAD-Start is a project funded by Unitaid.