Rallying the Multitude to Free the (Generic) HCV Cure
Effective Responses to the Burgeoning Hepatitis C Pandemic Requires Solidarity Between the Global North and South
We can now cure the hepatitis C virus (HCV) with a coformulation of drugs that yields sustained virologic responses for all genotypes. Epclusa (sofosbuvir/velpatasvir), however, joins the ranks of other high-cost direct-acting antivirals that are inaccessible to the majority of the 150 million people living with chronic HCV around the world. Treatment activists need to escalate their advocacy and political pressure, draw on lessons from the AIDS movement, and emphasize conscientious solidarity among countries of the global South, as well as across countries in the North and South, to make universal generic access a reality.
Epclusa, approved by the U.S. Food and Drug Administration in June 2016, is a game-changing medication that is administered orally once a day for 12 weeks and reduces the need for genotype diagnostics, thereby saving money for cash-strapped budgets in lower- and middle-income countries. However, the $74,760 list price for Epclusa is expected to create enormous barriers to access. Public payers and private insurers in the U.S. alone are limited in how many patients they can cover. By contrast, the $1 trillion failed drug war could have funded Epclusa treatment for 13.4 million people -- four times the number of patients in the U.S. Adding to the public outcry, analyses by Andrew Hill of the University of Liverpool and his colleagues indicate that sofosbuvir can be produced with a 50% profit margin for as little as $62; thus, the current pricing of the cure is not justifiable.
The HCV movement requires the building of solidarity across borders because collective, cooperative actions are more powerful and resilient than individual ones. Universal rights to health can connect local struggles with international patient networks. Each struggle needs to be autonomous in how it employs strategies according to local conditions, but can gain strength by uniting with global movements.
In a demonstration of both types of solidarity at the 21st International AIDS Conference in Durban, more than 150 South-African and Indian activists and comrades from the North marched to the Indian consulate to deliver a petition letter. South Africa has one of the highest HIV burdens in the world and relies on Indian generics for the majority of its ARVs. The Indian government has recently faced external pressure because its patent laws take advantage of flexibilities that enable generic manufacturing. The Lawyers Collective fights for this enabling environment and for the preservation of civil society space. This year, the Indian NGO has been suspended from receiving international funding, which potentially undermines its work. Without strong advocacy for generic access, developing countries' current ARV and future HCV direct-acting antivirals supplies are in jeopardy.
This action demonstrated good practices for North-South solidarity. Activists from the global North followed the collective leadership style, listened to organizers from the South, recognized their privilege, acknowledged critiques of their own governments, and worked to not impose their own agendas. They offered legal aid and funding, helped occupy the media center, and urged media coverage in the North.
Through practices of conscientious solidarity, activists can ground their advocacy in broader concerns of power imbalances and social inequalities to challenge the commodification of the cure, oppose drug monopolies, and demand legal flexibilities to liberate generics. Treatment activists can and must demand changes to the rules to make direct acting antivirals (DAAs) affordable for everyone who needs it.
This article was provided by Treatment Action Group. It is a part of the publication TAGline.
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