The barriers to accessing affordable Hepatitis C Treatment In Nigeria are mostly placed in front of people by powerful groups with vested interests.

The Difficulties of Getting Hepatitis C Treatment In Nigeria

Oh, I had a bad experience on Friday that leads me to write this rather long post about getting Hepatitis C Treatment In Nigeria and poor countries generally.

Meanness and Moneygram

I went to pick up some money from Money Gram sent to me by one of my Facebook Hep C support group members who lives in Nigeria, but Money Gram refused to hand over the money because I did not know the lady personally. That is to say that I had not physically met her.

I explained to the Money Gram employee this lady was a friend and I was helping her to get medication for Hepatitis C, a potentially fatal disease.

I explained that we were friends on Facebook.

The Money Gram person said that Money Gram did not allow “third party transactions” and only allowed money to be sent to friends or family. She told me that Money Gram did not consider FaceBook friends to be real friends and then she refused to hand over the money.

Then I asked, “So if I had walked in and said that I and this lady had met physically at some time in the past you would have given me the money?”

“Yes.”

Then the supervisor, who had been listening from a short distance away, walked over and said, “”Actually because the money is from Nigeria we would not let you have it even if you were a personal friend because of money laundering concerns.””

At this point, I noticed that my blood temperature was rising.

“So you are saying that a Nigerian person can not send money overseas?”

“Only to relatives or personal friends.”

Now my blood was starting to boil and I responded,

“Really? Seriously… in the 21st century, we can’t have real friends who we have never physically met? ”

Money Gram person, “That’s correct. You would need a Nigerian passport to collect this money.”

Sadly I got very close to losing my temper at this point but realized that I wasting my time talking to these “people” who were just cogs in a vast unfeeling profit machine called Money Gram. There would be nothing to be gained by me losing my temper, I was talking to cogs.

But I was so very, very annoyed. Really, really frustrated because I really badly wanted to get this medication to this lady in Nigeria. We had been communicating for a considerable time and Nigerians with Hep C have a hard enough time of it trying to get Hep C treatment without more barriers being thrown up.

My sad task was then to send a message to our group member and give her the bad news and try to work out some other way of her sending the money

Moneygram is a USA based and USA owned company which, like most companies, is purely and totally interested in maximizing profits. Without telling the sender that I would not be given the money she sent me Moneygram will not refund her money for at least one month.

Getting Hepatitis C Treatment In Nigeria

Every day I get at least a couple of emails from people in Nigeria asking how to get Hepatitis C treatment in Nigeria.

Whilst we don’t have exact numbers it is likely that more than 2% of Nigerians have Hep C… that’s about 5 million people with Hep C.

Getting Hepatitis C treatment in Nigeria for most of those people is very difficult. Cost is the biggest issue.

Living in Nigeria

The population of Nigeria is a little under 200 million people. At least 5 million Nigerians have Hepatitis C.

In Nigeria, the basic wage is about US$80 per month whilst highly skilled workers such as teachers, managers, tradesmen, doctors and such rarely earn more than US$160 per month.

About 25% of the population is unemployed with almost no income.

For many people in Nigeria, the cost of generic Hepatitis C medication will be equal to almost a year’s wages.

Hepatitis C Costs in Nigeria

Hep C Testing in Nigeria

The cost of getting a Hepatitis C viral load test to confirm the Hep C infection is very expensive. In relative terms, it would be at least one month’s total income.

Below is an email from a guy who tested positive for Hep C antibodies but had no symptoms. He decided to get a viral load test to confirm his Hep C infection. He explained the process to me.

Hello Sir,

Sorry, I didn’t respond to your query on the cost amount when I did my viral load test, I was busy this last week and had no chance. Actually it was subsidized for me by a charity so it cost me N28,000.

But I learn it is N45,000 (US$125) that people are charged with the private clinics. I don’t think any Government hospital in Nigeria does this test except only in private labs. But if any person needs help with the test in Nigeria maybe I can help redirect them to the foundation that helped me so if they are lucky might get the test cheaper. This will be my little contributions to help people with HCV in this part of the world.

thanks

F###

This means that if a person on the basic wage in Nigeria cannot get any form a subsidy for their viral load test they must part with two months of wages to get the test. Then, if they discover that they have a Hep C infection, there is the cost of medication.

The Cost of Hepatitis C Medication in Nigeria

Here is part of an email conversation I am involved with at the moment:

Good day Sir. I’m Francis from Nigeria.

Please I’ve a friend who’s also a Nigerian and he is Hepatitis C positive, he has met his doctor for treatment and the doctor recommended some drugs for him which among the drugs are interferon injection(3x for 3week), Ribavirin(1 daily for 1 month) and Hepantivir(1 daily for 1 month). I just asked some questions concerning those drugs and his diet on your page(Hepatitis C treatment cure and community) and I was directed by some of the group members to contact you for your own opinion and also for you to help us recommend some effective and not expensive drugs we can use to cure the virus and how we can get them here in Nigeria. Thanks!!!

I suggested to Francis that Interferon was both ineffective and highly toxic and that his friend should consider using Sofosbuvir + Daclatasvir as a better option. I suggested that he try a government hospital where I had heard that he might possibly be able to buy 12 weeks of Sofosbuvir + Daclatasvir for around 100,000 naira (about US$300).

Hello! Good day Sir. Please Sir, I went to a government hospital here in my city to check the drugs(Sofosbuvir & Daclatasvir) as you recommended but I couldn’t get the drugs there. So today I went to a drug market in my city to check the drugs and luckily I saw the two drugs there in the market, so I decided to take their pictures and send to you for you to help me and confirm if they’re actually the right and original drugs I should buy and use for my treatment. Thanks!!!

Francis sent me photos of MyHep (Sof)  and MyDekla (Dac) by Mylan. I wrote back and asked him what they were charging him

Oh! Sorry Sir for not replying your message on time, I slept off. They said they’ll sell the two drugs to me at the cost of N70,000… I think that should be $193

But one the sellers said others sell lower than that price and he can show me some shops I can get them at cheaper price for 3 bottles but due to I came late and those shops have closed before I came to the market. So I decided to go back and come back next time for it.

I wrote back to Francis and asked him if that price was for the one bottle of Sofosbuvir and the one bottle of Daclatasvir (4 weeks treatment) or for the entire 12 weeks treatment. Francis wrote back and told me that it was just for the 4 weeks treatment. 12 weeks treatment would cost a total of 200,000 nairas (about US$650) Basically an entire year’s wages. As I supply 12 weeks of Sofosbuvir + Daclatasvir to people in impoverished situations in Nigeria for 120,000 nairas including shipping the price at the drug market was obviously not a fair price.

Also this week I was communicating with a woman in Nigeria who was buying generic Epclusa for her father from his doctor. Her doctor was charging US$450 per bottle whereas the correct price should be around US$300 per bottle.

So the people of Nigeria are being screwed every which way. They can not access affordable Hep C treatment through their hospitals.  Their pharmacists and other retail outlets are selling at about double the correct price. Even their doctor are making great money out of the disease.

A Nigerian “Drug Market” where a 12 weeks treatment with generic Hepatitis C medication will cost more than 250,000 nairas… About US$600. Or almost one year’s wages.

The Hep Stigma in Nigeria

Then on top of that, there is a terrible stigma associated with having Hep C in Nigeria. It is considered a sexually transmitted disease by just about everyone, even the doctors there.

Most people who contact me from Nigeria are so ashamed of having Hep C and so afraid of others finding out that they have Hep C, that they pretend that they are making inquiries on behalf of a friend or relative.

Recently I had a long email conversation with a Nigerian woman who was considering killing herself because when she learned that she had Hepatitis C and told her husband he became furious accusing her of infidelity. He violently threw her out of their home. He assumed that she must have been having sex with another man because he incorrectly believed Hepatitis C to be a sexually transmitted disease. Now for the shock… Her husband was a doctor!

The Nigerian government does not fund Hepatitis C treatment. The best that can be hoped for is that they will supply a generic Hep C treatmentat a fair price, but this is rare

What Hope For People With Hep C in Nigeria?

In 2017, whilst attending the International Liver Conference,  I spoke with GILEAD’s man in charge of supplying their Hep C medicines to Africa, he was an African man from Senegal now living in the USA.

I asked him about the problem of cost, the fact that almost no person anywhere in Africa could afford GILEAD’s Hep C medication but he was evasive.
So I asked a few simple questions such as what the infection rate was, on average, in Africa. To cut a long story short this guy did not know. So I asked about Gilead’s so-called Compassionate Access Plan and got a very long answer about how only Sofosbuvir had been approved and that drugs like Harvoni and Epclusa needed to be approved by each individual country and this was an ongoing thing on a country by country basis.

Okay… more evasive answers.

Gilead’s Compassionate Access Plan in Nigeria

So I decided to get specific and asked about Nigeria. What was the situation in Nigeria?
Well according to this guy there are a lot of people in Nigeria who can afford to pay full price for Harvoni or Epclusa and that many people prefer to buy the brand version rather than the generic version.
Okay, I asked, but what about all the 5 million or so poor people in Nigeria with Hep C who could not even afford the generic version?
Gilead’s guy explained to me that these people had access to treatment through Gilead’s Compassionate Access program. He explained that all that needed to happen was that the poor infected person had to download the Compassionate Access form and print it out and then take it to his or her doctor.

The doctor could fill it in the form and explain to GILEAD, in medical terms, that the person applying for compassionate access to Hep C treatment would die soon if they did not get treatment. Further, they would need to provide proof that they could not afford to buy the treatment through normal channels. Then the doctor only had to sign the form, send it to Gilead in the USA and Gilead would give it due consideration and probably send the medicines for only $125 per bottle. That is they would sell the medicine to the poor Nigerian for US$375 for a 12 week treatment, which, by the way, is more than I charge.

How Many Nigerians Has Gilead’s Compassionate Access Plan helped?

Again, to cut a long story short, I asked how many people in Nigeria had been able to access Gilead’s Compassionate Access Plan.
Well, it turns out the answer to that was NONE.
So how many people in all of Africa had accessed Gilead’s Compassionate Access Plan?
Again to cut a long story short… It turns out the answer is:

“One.”

A person from Cameroon had done it.
So in all of Africa just one single person ( out of about 30 million people or so people in Africa with Hep C) had got treatment through Gilead’s Compassionate Access Plan.
I have to admit that even I, a great cynic, was surprised by this appalling number. It was a sad, pathetic joke. A joke on humanity by an inhuman company.

My Global Hepatitis C Support Project.

The situation in Nigeria is repeated across the world in many, many countries where corruption and poverty combine to make access to Hepatitis C treatment almost impossible for millions of people.

My global Hepatitis C Support program offers 12 weeks of Sofosbuvir + Daclatasvir to any person in an impoverished position in any country for US0 including shipping.

There is no requirement to prove a low-income status. We trust people.

To the best of my knowledge, the last two years my global Hep C support program has provided more low-cost treatments to people in Africa than Gilead’s so-called Compassionate Access Plan, at a lower cost.

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