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Viral hepatitis poses a significant global health challenge, with 354 millions of people affected by hepatitis B and C. Despite the availability of affordable and curative treatments, progress towards eliminating hepatitis has been limited, especially in low- and middle-income countries. To address this funding gap, a coalition of partners is exploring a unique financing approach in Cambodia. This article discusses the proposed mechanism, its potential impact, and the opportunity for other health programs to benefit from a similar financing solution.
Hepatitis C Virus (HCV), responsible for 17% of all viral hepatitis cases, is a preventable and curable disease. With just 12 weeks of once-daily oral treatment using direct acting antivirals (DAAs), HCV can be eliminated. The World Health Assembly has set a goal to eliminate viral hepatitis by 2030, presenting a rare opportunity in the field of medicine.
Integration of HCV tools and services
To enhance accessibility and efficiency of HCV screening, diagnosis, and treatment, and to implement the primary health care-based program immediately, Hepatitis C Virus services are embedded within primary care settings. This approach ensures that individuals receive comprehensive care, including testing, counselling, and antiviral therapy, thereby reducing the burden of HCV and improving patient outcomes.
The Funding Challenge
While a handful of high-income countries are on track to achieve the elimination commitment, many low and middle-income countries struggle to roll out comprehensive health programs due to financial constraints. Major health program funders often have limited interest in HCV, exacerbating the funding gap and hindering progress.
In response to the funding challenge, a coalition of partners, including Drugs for Neglected Diseases Initiative (DNDi), Medecins sans frontieres (MSF), Treatment Action Group, and FIND, is working together to bridge the funding gap for HCV elimination. Their focus is on finding innovative ways to secure funding and support the implementation of elimination programs, particularly in resource-constrained countries.
The Financing Approach
The proposed financing approach in Cambodia aims to leverage the economic benefits of HCV elimination to fund the program itself. An analysis in Cambodia revealed that eliminating HCV would generate economic benefits of USD 145 million over 10 years, surpassing the estimated program cost of USD 60 million during the same period.
To implement the program immediately, a third-party social investor would provide pre-financing, which would be repaid by the Royal Government of Cambodia (RGC) once the economic savings materialise. This approach allows the RGC to transfer investment risk to the investors. If the program achieves its objectives, the investors would receive interest as remuneration for the risk taken.
Applicability and Potential Impact
The proposed financing solution not only has great potential for HCV elimination efforts globally but can also be applied to other health programs that require upfront investment and have the potential to generate economic benefits. By adopting a similar financing approach, countries can address the funding gap for various health initiatives, leading to improved health outcomes and cost savings in the long term.
The coalition seeks actors interested in generating a proof of concept for this financing solution and contributing to HCV elimination in Cambodia. The Royal Government of Cambodia has already demonstrated its commitment to the Viral Hepatitis Response by allocating USD 1 million to the cause. Interested parties are encouraged to contact the coalition to learn more about this innovative financing approach.
Conclusion
By addressing the funding gap through creative financing mechanisms, we can accelerate the progress towards eliminating hepatitis globally. The proposed financing approach in Cambodia presents an opportunity to leverage economic benefits and transfer investment risk, ultimately improving the accessibility of HCV elimination programs. Furthermore, this approach can be extended to other health programs, opening doors for impactful investments in healthcare.
Let us seize this opportunity and work towards a future free from the burden of viral hepatitis.
Signatories
- Emma Hannay, Chief Access Officer, FIND
- Dr. Isabela Ribeiro, Viral Disease Cluster Director, DNDi
- Joelle Dountio Ofimboudem, Acting HCV Project Director, TAG
- William Hennequin, Operations Director, MSF
- Clara Marköö, Manager, KOIS
- Serena Guarnaschelli, Partner, KOIS
