Hepatitis C : A virus won’t stop us!
Hepatitis C : A virus won’t stop us!
A community led study for people who inject drugs, people living with Hepatitis C, people living with HIV & Hepatitis B and C coinfection at the primary health care settings in Malaysia
Please read the study paper here : 1-Revised – Final of Final
Pihak kami telah melancarkan satu buku panduan yang dinamakan Panduan Diagnostik Virus Hepatitis C untuk membantu aktivis memahami perkara berkaitan dengan perkhidmatan ujian pengesanan, pengesahan, dignostik dan juga rawatan Hepatatis C di dalam Bahasa Malaysia. Sila klik pautan berikutan untuk membaca buku panduan ini https://mtaagplusmalaysia.files.wordpress.com/2020/06/activistguide_malay.v4.pdf
Wednesday, 20 May 2020
PETALING JAYA: The government is urged to look into prevention and treatment strategies in the country’s prisons immediately to prevent Covid-19 outbreaks like the ones taking place in prisons overseas.
Positive Malaysian Treatment Access and Advocacy Group (MTAAG+) director Edward Low said in an interview that no announcement had been made yet on the number of inmates tested for Covid-19 and there was concern that the Prisons Department does not have the capacity to test prisoners for the disease.
“Prisoners living in over-crowded prison conditions could exacerbate a Covid-19 outbreak if it occurs,” he said on Wednesday (May 20).
Low said the Prisons Department should be given resources and test kits to test the prison population in Malaysia, estimated to be around 84,000.
In a statement issued by MTAAG+ on the same day, Low urged the Health Ministry and various stakeholders to collaborate with community-based organisations in various states to look into prevention and treatment strategies.
Currently, the ministry had focussed on migrants and those in detention centres and little attention on the prison population which are housed in confined spaces with no room for physical distancing, he said.
Based on this concern, Low also urged the authorities not to send minor offenders to jail.
While Malaysia’s efforts in battling the spread of Covid-19 among the various known communities were proving fruitful, the delay in implementing prevention and treatment measures in prisons could result in the next wave of outbreak, he said.
“If such outbreaks occur, they will place a considerable heavy burden on the health-care services in prisons, as well as increase the likelihood of the Covid-19 spread within prisons and places of detention,” he said.
It could also spread from prisons into the community, and if that happens, all of the country’s efforts in containing the disease would be wasted, he added.
Read more at : https://www.thestar.com.my/news/nation/2020/05/20/ngo-urges-govt-to-plan-for-possible-covid-19-outbreak-in-prisons?fbclid=IwAR2Oz6y1VNDciV9cCnIZS_wsNdUIDQ9GogoDRn4ia9g3VybQUCdtNSHDAfg#.XsVsrou9tcI.facebook
20th , May 2020
COVID-19 Testing and Treatment in Prison Settings: No One Left Behind as Malaysia Move Forward in the Elimination Strategy of this World Pandemic.
PETALING JAYA – When Malaysia tests confirmed that one of those samples was infected with COVID-19 on 11 th March 2020 1 , which signaled the coronavirus world pandemic has invaded the country in an isolated and random manner in the community. Immediately on 18 th March 2020, the whole nation started our first phase of two weeks movement control order (MCO) with extension of 3 phases until 9 th June 2020 in an attempt to curb this pandemic from racking havoc of disasters in Malaysia, which has resulted in more than 4.2 million infections with 287,000 deaths worldwide 3 . Up to date Malaysia coronavirus totaled to 6,941 with 133 deaths, and 5,223 recovered 4 – quite a success story as compare to our neighboring ASEAN countries.
While Malaysia’s efforts in battling the spread of COVID-19 among the various known
communities are proving fruitful, with our COVID-19 positive cases way under control at 7%, which is below the 10% benchmark set by the World Health Organisation (WHO), and the death rate at a low 1.6% compared with the global rate of 5.7%. However, we must not forget those in the prison settings of which Malaysia has yet to show any sign of initiation strategy of the COVID-19 prevention and treatment currently.
As evidence base incident proof what has happened in America to further elaborate and in support of the facts. In mid-March 2020, the first case of COVID-19 was diagnosed at Riker’s Island, the main jail complex in New York City. Within 2 weeks, more than 200 cases were diagnosed within the facility, despite efforts to curb the spread. The situation at the Cook County jail in Chicago is similar, with about 350 incarcerated persons and staff members testing positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus as of early April 2020. Many other jails and prisons have reported outbreaks of COVID-19 and related deaths.
Quoting UNODC, WHO, UNAIDS AND OHCHR joint statement on COVID-19 in other close settings* that highlighted the rate of infection of diseases in such a confined population is also higher than among the general population. There are currently 28,525 confirmed cases of COVID-19 among people incarcerated in U.S. prisons and jails, and 393 confirmed COVID-19 deaths. Due to under-testing and under-reporting, the true numbers are likely to be much higher .
As per WHO’s highlight that the response to COVID-19 in prisons and places of detention, though more challenging and requires a whole-of-society approach, efforts to control COVID-19 in the community are likely to fail if strong infection prevention and control measures, testing, treatment and care are not carried out in prisons and places of detention as well. Prison health is part of public health so that nobody is left behind.
As such MTAAG+ like to strongly urge the Ministry of Health of Malaysia and the Malaysia various related stakeholders in collaboration with community base organisation of the various state to immediately looking into the possible COVID-19 prevention and treatment strategies in addressing this issue, which currently is still a big gap and afraid in delaying will cause a next wave of outbreaks in Malaysia. If such outbreaks occur will place a considerable demand with heavy burden on the health-care services in prisons, as well as increase the likelihood of the COVID-19 to spread within prisons and other places of detention and from such settings back into the community, which will bring all the affords done in Malaysia back to square one.
MTAAG+ was formed on the 21st, December, 2005 by a group of People Living with HIV (PLHIV), which realised the need to form a strong poz-representative in Malaysia to speak out and be heard in international events. The priorities of MTAAG+ are the national implementation of TRIPS flexibilities in law and practice, and the prevention of IP provision in bilateral and plurilateral trade agreements that are against public health, in particular access to affordable medicines.
Contact Person: Mr Edward Low
Contact No. 03-7931 2066 (Office) / 012-327 8812 (Mobile)
HCV Services Website: https://myhepcservices.com
 First sporadic Covid-19 case in Malaysia. https://www.nst.com.my/news/nation/2020/03/573951/first-sporadic-covid-19-case-malaysia
 Malaysia extends MCO by another two weeks to April 28. https://www.theedgemarkets.com/article/mco-be-extended-april-28
 COVID-19 live updates: Total number of cases passes 4.2 million. https://www.medicalnewstoday.com/articles/live-updates-coronavirus-covid-19#1
 Malaysia Coronavirus update with statistics and graphs. https://www.worldometers.info/coronavirus/country/malaysia/
 COVID-19 in Prisons and Jails in the United States. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2765271
 UNODC, WHO, UNAIDS and OHCHR joint statement on COVID-19 in prisons and other closed settings. https://www.unaids.org/sites/default/files/20200513_PS_covid-prisons_en.pdf?utm_source=UNAIDS+Newsletter&utm_campaign=9c7037a29b-20200513_PS_COVID_and_Prisons&utm_medium=email&utm_term=0_e7a6256e25-9c7037a29b-114146541
 UCLA COVID-19 Behind Bars Data Project @uclaprisondata tweets on 16 May 2020. https://twitter.com/uclaprisondata/status/1261469839345868800?s=03
 Prevention and control of COVID-19 in prisons and other places of detention. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/novel-coronavirus-2019-ncov-technical-guidance-OLD/coronavirus-disease-covid-19-outbreak-technical-guidance-europe-OLD/prevention-and-control-of-covid-19-in-prisons-and-other-places-of-detention
People Living with HIV and Marginalized Communities must be at the centre of all Universal Health Coverage (UHC) related policies, programmes and Discussions
Bangkok, 12 December 2019 – On the International day on Universal Health Coverage (UHC), Asia Pacific Network of People Living with HIV (APN+) calls on all governments in the Asia pacific region to make full use of all flexibilities provided in the WTO TRIPS Agreement to increase access to affordable medicines. APN+ also urge governments to reform patent laws to include these flexibilities and reject TRIPS-Plus provisions in Free Trade Agreements that will delay in accessing cheaper medicines.
“UHC commitments require our governments to ensure access to essential medicines,” said Shiba Phurailatpam, Regional Coordinator of APN+. “Many of the medicines on the WHO’s Essential Medicines List for HIV, TB and Hepatitis C are patented in many of the countries in the Asia-Pacific region. Using flexibilities in the TRIPS agreement to ensure access to safe, effective and affordable generic medicines will contribute immensely in achieving UHC and funds being used for expensive patented medicines can be used to improve other health care related service. The use of TRIPS flexibilities has been clearly recognized in the Political Declaration signed by all our governments at the UN High Level Meeting on UHC in September 2019,” he added.
Today, the cost of patented medicines takes up a large chunk of the healthcare budget in many countries and guarantees the profit of big multi national pharmaceutical companies at the cost of lives of millions of people in the developing countries. The pricing, patenting and licensing policies of multi national pharmaceutical companies are resulting in fractured access in Asia-Pacific countries.
“For the Asia-Pacific region, this is of utmost importance as we contribute large chunk of HIV, HCV, TB epidemic to the global burden, and middle income countries in our region are routinely excluded from price discounts and licensing deals,” said Edward Low of Positive Malaysian Treatment Access and Advocacy Group (MTAAG+). “In Malaysia for instance we have used compulsory licensing to ensure access to affordable Sofosbuvir (HCV drug) in 2017 which has been critical to the rollout of HCV treatment in our hospitals and to help in the research being conducted by DNDI on a new treatment for HCV. The effectiveness of this approach has saved many lives and we call on our government to extend the compulsory license and continue using TRIPS flexibilities to improve our health care programmes,” he said.
“Countries in the Asia-Pacific region have been global leaders in the use of TRIPS flexibilities,” added Loon Gangte of the Delhi Network of Positive People (DNP+). “In India we have successfully challenged many patent applications on essential medicines ensuring generic availability of these medicines at lower prices. We call on all countries
in the region to adopt stricter patent criteria to prevent ever-greening patents on medicines and for the use of compulsory licensing to improve availability and affordability. Improved availability and far lower prices of medicines can be achieved through proper, unrestricted generic competition leading to a sustainable price for all kinds of therapy,” he said.
“Thailand has been a tremendous example for the region in using TRIPS flexibilities to support its Universal Coverage (UC) programme,” said Chalermsak Kittitrakul of AIDS Access Foundation. “Our government issued compulsory licenses on medicines for treating HIV, heart disease and cancer between 2006 and 2008 making savings of millions of dollars for the UC programme that were then used to introduce additional programmes and treatments in our healthcare programme. The use of TRIPS flexibilities is essential to the sustainability of any UHC programme,” he said.
However, there is also great concern that many countries in the region are negotiating Free Trade Agreements (FTA) that will undermine the ability of the governments in the region to use TRIPS flexibilities. “In Vietnam the FTA with the European Union (EU) has introduced TRIPS-plus measures and we are extremely concerned that these will undermine access to affordable medicines in our country,” said Do Dang Dong of Vietnam Network of People Living with HIV (VNP+). “The Regional Comprehensive Economic Partnership Agreement (RCEP) also has TRIPS-plus demands made by Japan and South Korea. We call on the ASEAN governments to release the text of the RCEP negotiations and reject all TRIPS-plus provisions in the text,” he added.
“As the regional network of People Living with HIV working for and by people who are most marginalized we urge our governments to put people living with HIV, people with TB, people with hepatitis C and marginalized groups like people who use drugs, sex workers and the LGBTQI communities at the centre of all UHC related policies, programmes and discussions,” added Shiba Phurailatpam of APN+. “The experience with the successful scale up of HIV prevention and treatment programmes has demonstrated that people living with HIV and marginalized communities have the most important expertise in the design and rollout of health programmes and in the use of TRIPS flexibilities to ensure access to medicines for all. Our participation and involvement will contribute in bringing our region one step closer to achieving UHC for all,” he said.
As people living with HIV, UHC is of particular concern for our lives and health. The Asia Pacific Network of People living with HIV/AIDS (APN+) calls on Governments to:
APN+ also calls on developed countries to immediately cease putting pressure on developing countries when they use TRIPS flexibilities to improve access to medicines.
***************** Contact:Mr. Shiba Phurailatpam,email@example.com, +66 8660 00738
We have recently launched the above site for anyone to locate the nearest government clinic or hospital that provide screening, confirmatory test, diagnostic and also treatment of Hepatitis C. Please click to the link to check out https://myhepcservices.com/
Baru-baru ini pihak kami telah melancarkan satu laman untuk kemudahan orang ramai mengenalpasti klinik atau hospital kerajaan yang menawarkan perkhidmatan ujian pengesanan, pengesahan, dignostik dan juga rawatan Hepatatis C. Sila klik pautan berikutan https://myhepcservices.com/
The majority of people living with HIV reside in middle-income countries but this is also often where the treatment gap is the largest.
So why? Why are drugs not reaching everyone who needs them?
What stops universal health coverage being achieved?
Our partners, from middle-income countries around the world, share their perspectives and frustrations about what the barriers are; the consequences; and what needs to change:
“We appreciate the commitment made by governments to Universal Health Coverage but achieving it will be a distant dream as long as the cost of medicines remains unaffordable,” says Shiba Phurailatpam, Regional Coordinator of the Asia Pacific Network of People living with HIV (APN+).
“Health care programs in our region are already struggling with the high cost of patented medicines. Whether we achieve UHC now, soon, or after 100 years will depend on how soon our governments bring in affordable generic medicines,” says Phurailatpam.
Phurailatpam believes a dual-response is required, one which tackles both price and prejudice.
“Though the commitment to UHC exists in theory, marginalized communities in our region continue to struggle to access health care programs. Bringing UHC one step closer will only happen when people who are highly marginalized are put at the centre of all UHC related policies, programs and discussions.”
“We have a lot to learn from the HIV epidemic. The same drugs which used to be more than 10,000 US dollars per patient per year are now less than $100 because of generic production and competition. If we are serious about achieving UHC then we have got to sort out the issue of patented drugs and their high cost.”
Alma de León, ITPC’s Regional Director for Latin America and the Caribbean, agrees: “If we want to achieve universal coverage, drug patents must be eliminated,” de León says. She takes a hard line: “No more patent registration on life-saving drugs.”
De Leon also believes there is not enough take up of TRIPS flexibilities in order to prevent or challenge unmerited monopolies or other intellectual property barriers, something she is working on with civil society organizations in the region, to build on and change the medicine landscape.
Mykyta Trofymenko, Intellectual Property Counsel at 100% LIFE affirms that unmerited patents is also what’s stretching the health budget to breaking point in Ukraine.
“Evergreening patents seriously obstruct access to medicines in Ukraine. According to 2017 data, one medicine monopolized by two secondary (evergreening) patents takes up a staggering 40% of the HIV budget and more than 10% of the whole state budget for procuring medicine.”
‘Intellectual property’ can at first seem a daunting topic to people without a technical or legal background, but Aissam Hajji, ITPC-MENA’s Advocacy Officer, explains why it’s essential for all health advocates to engage with this issue: “Experience has shown that action taken by civil society has a direct impact on stimulating competition,” he says. “It’s really important for civil society to understand the impact of monopolies on medicines and the important role they can play. Medicines no longer benefit from a status of ‘public goods’ [as Alma would like to see happen], instead they are mere products to profit from. With an absence of competition, these profits are unrestricted.”
It is clear from our work on access to medicines, that the ambitious health targets set cannot be achieved unless we tackle the patent problem.
The commitments to UHC are being undermined by intellectual property barriers, especially in middle-income countries which are frequently excluded from pricing deals and licenses due to their income classification. However, this can change. Partners of the Make Medicines Affordable campaign are removing barriers and setting precedents to create long-term change.
Wednesday, 13 Nov 2019
But a lot of the issues have been resolved and the number of patients to be screened and treated are expected to increase exponentially next year.
The process of getting laboratory support, coordinating with hospitals for patients to be treated and procurement that did not meet specifications were among the challenges they had faced, said the ministry’s National Head of Gastroenterology and Hepatology Datuk Dr Muhammad Radzi Abu Hassan.
“We have rectified the problems and we expect the number of patients screened and treated will increase markedly next year, ” he said in a dialogue between civil society organisations and the ministry in a multi-stakeholder forum on Hepatitis C here recently.
Besides the logistics issues, Dr Muhammad Radzi said that at the initial stage, there were fewer patients treated because many of them had liver cirrhosis and were treated in hospitals, which required more of the allocated medication.
But with the efforts to decentralise Hepatitis C screening and treatment this year, more were expected to be diagnosed and treated next year, he added.
“We will have screening and treatment in selected health clinics in every state beginning next year.”
Dr Muhammad Radzi said that with the decentralisation, the ministry would also provide clinics with rapid test kits for better access to screening. The rapid test is to test for Hepatitis C antibodies.
If tested positive, the patient would need another test to confirm if treatment is needed.
In total, he said the ministry and the Foundation for Innovative New Diagnostics (FIND), funded by Unitaid, had screened more than 50,000 high-risk people this year.
FIND, in collaboration with the ministry, had tested out and introduced the Hepatitis C rapid diagnostic test in one health clinic in December last year and in 25 health clinics starting March.
The programme had screened 15,148 patients and 2,031 patients were tested positive for Hepatitis C while 11,523 patients were screened during the ministry’s World Hepatitis Day one-week campaign in July and 220 patients were tested positive, said FIND HCV country project manager Sem Xiao Hui.
For the other cases (of the 50,000) while the rapid test was being studied, health clinics had taken blood samples and sent them to the hospitals or public health laboratories for testing.
In 2017, Universiti Malaya consultant hepatologist Prof Dr Rosmawati Mohamed said that more than 500,000 Malaysians aged between 15 and 60 were estimated to be infected with Hepatitis C, but 74% or 386,000 had active or persistent infection which required treatment.
In July 2017, The Star carried a front page story highlighting the plight of Malaysians who suffered from Hepatitis C as only a fraction could afford the medication that can cost up to RM300,000 for the full course of treatment.
Subsequently, the Cabinet gave approval to issue a government-use licence to enable the import of generic versions of the Hepatitis C drug sofosbuvir.
We’re pleased to share the Activist Guide and training curriculum if you could share in your networks or on social media (TAG will have some tweets/FB posts that can be re-tweeted).
Happy Halloween! What’s scarier than government inaction and Pharma greed that prevents people from getting tested and accessing affordable hep C treatment?…NEW Activist Guide and training curriculum helps activists learn how to take back our diagnostics!