PATH leads new hepatitis C prevention project with investment from Unitaid in harm reduction

Related program: HIV, Tuberculosis, and Viral Hepatitis

The new investment provides a major boost for harm reduction efforts to close the hepatitis C testing and treatment gaps among high-risk groups in low- and middle-income countries.

The Unitaid-funded and PATH-led four-year HCV Combination Prevention in PWID and Prisoners Project (HEPC3P) will address key access barriers that prevent the introduction and scale-up of hepatitis C virus (HCV) products and interventions in low- and middle-income countries. The project, which launched on January 1, will work with stakeholders to accelerate uptake of HCV prevention and treatment services among people who inject drugs (PWID) and people in prison, two population groups at high risk for HCV acquisition.

HCV is a viral infection that causes liver inflammation and can lead to serious liver damage in 20 percent of those with chronic HCV disease. It disproportionately affects PWID and people in prison, who are often highly marginalized and vulnerable. Globally, 39 percent of PWID and 26 percent of people in prison have an active HCV infection. HCV combination prevention strategies, including high coverage of needle and syringe programs, opioid agonist therapy, chronic HCV treatment, and addressing underlying barriers to service access, can dramatically reduce incidence toward elimination of HCV. While innovative, quality-assured HCV prevention, testing, and treatment products exist, their availability and uptake among marginalized populations in low- and middle-income countries are limited due to cost, supply, delivery, demand, and adoption barriers.

HEPC3P will contribute to closing the HCV prevention and testing gaps through increased access to new and underused tools for prevention, and through a “treatment as prevention” approach among PWID and people in prison in India, Nigeria, South Africa, Ukraine, and Vietnam. Together with country stakeholders, PATH will integrate HCV testing and treatment within harm reduction programs and generate evidence on two infection prevention products: low dead space syringes (LDSS) and long-acting depot buprenorphine (LADB), a drug used in opioid agonist therapy. HEPC3P will achieve impact in driving down new HCV infections, increasing equity and value for money through four critical outputs:

  1. Evidence generation for adoption of new and underused HCV products including LADB and LDSS in community harm reduction programs and prisons.
  2. Market shaping for new and underused HCV prevention, diagnosis, and treatment tools.
  3. Extensive and meaningful engagement of stakeholders—including communities, PWID, and people in prison—in the design, delivery, and monitoring of HCV services and as advocates for HCV prevention.
  4. Effective transition and scale-up of HCV prevention and treatment services for PWID and people in prison.

HEPC3P brings together a dynamic team of country-based and global colleagues with expertise in harm reduction, HCV, HIV, and service delivery innovation; expertise in generating evidence that informs guidelines, policy, and financing; and a deep understanding of human-centered design and market shaping. HEPC3P partners include Population Services International, the London School of Hygiene and Tropical Medicine, and the University of Bristol and technical partners The Hepatitis Fund and the Medicines Patent Pool. Unitaid has also funded two complementary projects, led by Frontline AIDS and Médecins du Monde. Together, these three projects will work in a total of 10 countries to generate essential evidence to inform guidelines, spur increased financing, and catalyze price reductions to effectively scale up combination HCV prevention.

Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose, and treat diseases more quickly, cheaply, and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV, malaria, and tuberculosis, as well as HIV co-infections and co-morbidities including advanced HIV disease, cervical cancer, and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic. Unitaid is hosted by the World Health Organization. For more information, visit