In September 2022, Gilead launched a 4-year public-private partnership with the Partnership for Health Advancement in Vietnam (HAIVN), Brigham and Women’s Hospital, Harvard Medical School and Beth Israel Deaconess Medical Center supporting the elimination of viral hepatitis in Vietnam and the Philippines. Gilead and HAIVN work together with a multi-stakeholder coalition, involving national ministries of health, academic stakeholders such as the University of Philippines-Manilla, provincial hospitals and primary healthcare centers to support this program.  The focus of the program is on person-centered approaches in training non-specialist community-based healthcare providers in prevention and management of viral hepatitis, incorporating education, screening, diagnosis and linkage to care for hepatitis B and C into routine patient visits for at-risk populations. This collaboration is a first-of-its-kind public-private-academic initiative to address barriers that limit viral hepatitis diagnosis and care by integrating such measures at primary healthcare level.

The initiative supports national priorities for Vietnam and the Philippines as access to diagnostics and treatment for viral hepatitis in both countries are still significantly limited and inconsistent. The World Health Organization has set a global target to eliminate viral hepatitis as a public health problem by 2030, calling for 90% of people with hepatitis B and C to be diagnosed, 80% of those eligible for treatment to be treated and a 65% reduction in mortality, in addition to developing preventative actions. Despite the important gains in biomedical technology and management of viral hepatitis, implementation of best practices and access to diagnostics and treatment in both countries are still significantly limited and inconsistent. At the current pace, Vietnam and the Philippines are not expected to reach WHO targets before 2050.

In Vietnam, out of a population of 97 million, nearly 7.8 million people have hepatitis B and over 900,000 have hepatitis C. Based on 2020 estimates from the CDA Foundation’s Polaris database, only 30% of Vietnamese people with hepatitis B have been diagnosed and only 3% treated. For hepatitis C, only 14% of cases have been diagnosed and 7% have been treated. In the Philippines, over 10 million people are infected with hepatitis B and nearly 450,000 with hepatitis C, with the care cascade standing at 5% diagnosed and less than 1% treated for hepatitis B and 23% diagnosed and 1% treated for hepatitis C.

This project seeks to provide evidence to support a shift from the current dependence on scarce and overstretched specialists to a broader group of primary care clinicians by studying the current primary care infrastructure in both countries. In an effort to strengthen the overall healthcare system in Vietnam and the Philippines through increased private sector investments, this initiative will explore the potential for primary care to serve as a more cost-effective and efficient mechanism to deliver high quality healthcare.

In February 2023, Gilead joined the governments of Vietnam, Philippines and the broader partnership coalition on high-level meetings in Vietnam and the Philippines to share results of the project’s baseline assessment. This included a landscape analysis of hepatitis care and treatment, as well as patient journey mapping to identify patient perspectives on accessing care and treatment barriers and enablers.

Policy makers in Vietnam and the Philippines committed to integrating viral hepatitis care into routine primary healthcare and innovating new models of care through a person-centred approach to improve patient experience and health outcomes. The partnership’s next phase involves co-designing and testing new models of care with the ministries of health, provincial governments, providers and patients to decentralize viral hepatitis treatment and care. If successful, this model of integrating specialist treatment into primary care and task shifting has the potential for application in many other disease areas.