Hepatitis C Treatment in the Philippines

The situation for people with Hepatitis C In The Philippines is difficult, especially for poor people.

Filipinos with Hep C face three major barriers to accessing treatment. These are the cost of the Hep C medicine, the cost of testing and the social stigma associated with having Hep C.

I am going to lead into my story about Hepatitis C treatment in the Philippines in a roundabout kind of way, to explain my connection to the Philippines.

My Connection to the Philippines

My earliest memory of being aware of the Philippines as a place is from a story I read when I was about 8 or 9 years old. It was in one of the primary school “reading primers” that were in circulation in Australia back in the late 1950’s and early 1960’s.

I remember that the story enthralled me; it was about a Filipino family who lived in a village by the sea and made a living from fishing from their little traditional trimaran. Sometimes they fished with cormorants and sometimes they fished with hand woven nets at night by the light of bamboo torches.

I really don’t remember many more details. Maybe there a typhoon, maybe there was a shark, but the gist of the story and a patchwork of images stayed in my mind for the rest of my life as representing a good life lived simply and happily.

My next interaction with the Philippines was when I was doing my Arts degree with a double major in History and Archaeology in the 1990’s. I decided to write a short paper on the Manila Galleon trade between Mexico and Manila.

I learned about the conquest of the Philippines by Spain and then by the USA.

Move forward to the 21^st century and in 2012 my son married a wonderful Filipino woman and the connection with the Philippines became much more personal when I, my wife, and our extended family traveled to my daughter-in-law’s village in Cebu to attend the wedding.

Now I have a Filipino grandson so my connection with the Philippines runs very deep indeed.

In the midst of all this I learned I had Hepatitis C in 2014 and in 2015 I started helping people around the world to access affordable Hepatitis C treatment.

Michael de Mesa: A Real Filipino Hero

Michael de Mesa and his wife Julie have done a huge amount to lift public awareness of Hepatitis C treatment options in the Philippines

I got a lot of inquiries for help with Hepatitis C treatment from all around the world but very few from the Philippines. Then in late 2015 I helped a Filipino man named Micheal to buy generic Hepatitis C treatment for himself.

I did not know at the time that Michael was a famous Filipino actor named Michael de Mesa.

After successfully curing his Hep C, encouraged by his wife Julie, Micheal bravely went public about his battle with Hepatitis C and mentioned that an Australian man had helped him get the medication.

Suddenly I began getting lots of inquiries from people in the Philippines who had Hep C.

A this stage the price of a generic Hep C treatment was over US,000 and it was not long before I realised that even the generic Hepatitis C medication was very difficult, or impossible, for most Filipinos. It was just too much money.

I also realised that the price was not the only barrier that people in the Philippines had to overcome to access Hep C treatment. Many people in the Philippines do not have bank accounts, so the normal methods of payment were not an option.

Even the fee for sending the money by Western Union was almost one week’s wages.

To put the cost of treatment into perspective the average wage in the Philippines is around US per week, most of which is spent covering the basic costs of living such as food and shelter for a family.

In other words, if a treatment cost US$1,000 that was 6 months wages. But for most Filipino’s there is almost no disposable income in their weekly wage. Maybe $5 or $10 at the most. So for a Filipino to save $1,000 would take 2 to 4 years of saving every spare cent and would only be possible if no other emergencies arose.

And, of course, many people earn less than $50 per week. And many people have no disposable income left over each week’s expenses.

Hep C and the Filipino Public Health Service

Like most Third World countries there is no free public health service in the Philippines. Wealthier Filipinos have health insurance but mostly Filipinos just try to live frugally and to put a little aside for emergencies. In desperate situations they will borrow from relatives if something like a medical emergency comes up. In many ways the Philippines is like a poorer version of the USA, where the wealthy do fine and the poor struggle along from day to day, just getting by.

On top of this there is no real knowledge of how wide spread the Hep C infection rates are in the Philippines.

I have not been able to get any exact figures out of the Philippines health services online information and, despite many attempts, I have not been able to get even one single reply from the emails I have sent to related Philippine government entities.

So how many people have Hep C in the Philippines?

The population of the Philippines is about 100 million people. If the Philippines has a similar rate of infection to a western country like Australia or the USA then the infection rate will be between 1% and 2% and there will be between one and two million Filipinos infected with Hep C.

However if the Philippines has Hep C infection rates like Romania or Serbia then there will be between 2 million 3 million Filipinos infected with Hepatitis C.

But Hep C infection Rates in the Philippines could be much higher because tests of Filipino immigrant applications to Canada indicate an infection rate of over 5% among applicants… This would mean that there are more than 5 million Filipinos infected with Hepatitis C.

How to Help the Poor

The situation for Filipinos infected with Hep C is similar to the situation of people with Hep C in Serbia, or Nigeria or even the working poor in the USA. They know there is a cure but they do not have any hope of saving enough money to afford even the generic Hepatitis C treatment.

Back to the Real World

Strangely, over the first couple of years after 2015, because I have been so involved with helping people around the world who could afford generic Hep C treatment, it took me a while to realise what was happening in countries where people could not afford generic Hep C treatment. It came to me that I had not really become involved in helping people infected with Hepatitis C living in impoverished situations.

One of the reasons for this was that poor people just did not bother writing to me because they could see the prices shown on my website were totally out of their reach.

Facebook Provides Hope.

Because most poor people rarely bothered to contact me through my website I was not getting a clear picture of the global Hepatitis C situation.

This is where Facebook made a huge difference.

A large part of my Buyers’ Club outreach program has been creating networks of people to provide peer support for people with Hepatitis C. To this end I started a Hepatitis C Facebook support group Hepatitis C Treatment Cure and Community that soon became the most active in the world.

Because this group is about support and not about selling medication there is no mention of prices and people from all around the world joined the group and talked about how things were in Nigeria or the Philippines and so on. They started to message me making inquiries and explaining how dire the situation was for people in impoverished situations.

This caused me to re-think how I offered and priced Hepatitis C medication.

Pricing for the Poor

I realised that there needed to be a price structure specifically for impoverished people so that price was not a barrier to Hepatitis C treatment.

So I decided on a price that was my cost price, that is what it cost me to purchase, process and deliver a 12 week treatment of generic Hepatitis C medication.

In the case of the Philippines I arrived at a price of 19,000 pesos which I later reduced to 18,000 pesos (US0)

This was still very high for many Filipinos, being about 2 months wages, but it was not impossible.

This price was also sustainable for me because it covered my costs.

But enough background… let me walk you through a typical conversation that I have with Filipinos and people from other places trying to get Hepatitis C treatment from a position of poverty.

This conversation began in August 2019.

A Typical Filipino Hep C Story

Let me share the example of a Filipino who I recently helped to start Hepatitis C treatment.

He is a taxi driver from the island of Mindanao

He wrote to me via Facebook Messenger

August 2019

helo sir greg have a good day to you. sir do you have a any idea where i can buy threatment for hep c. thnk you

here in the philipines in davao city

my name is Mary Da Linoza.

Hi Mary

The cost of a 12 weeks treatment is 19,000 pesos including delivery.

but sir i dont have money.

Hi Mary

I am sorry but I can not supply the medicines for free

ok sir greg. what if. the goverment of philipines will pay the medicine

what is the method of payment of you

becoz here in the philipines .. poor people like me. did not aford to buy medicine. goverment will provide. is possible to uou

Yes Mary I understand… it is difficult for you. Unfortunately I think that the government will not pay for the medicine.

ok sir i will ask tomorow the office of the president duterte. if its ok. to pay my med.. thank you sir

Okay, I sincerely wish you the best luck in this. Please let me know what happens

helo greg good morning the govertment here davao city philipines. no budjet to buy med.

Yes I would have guessed that would be true

may be 1 year from now. we can buy the med. we saving money for med. huh?

maybe it wil be more cheap and affordable after 1year. thank you greg

god bles and longlive you greg

The price may drop to around 15,000 pesos in the next 12 months

ok thank you. longlive the guy from tazmania. mabuhay auzzie

What tests have you had so far Mary?

nothing anymore we lost hope. when govertment say they dont have supply that med

Have you had any tests?

We had scan and SGPT test

what was the sgpt result? Do you have a copy?

actually greg I must confess that it is my husband who have hep c . he is ashamed to know other people. he is a taxi driver here in davao city. I pretend it is me because he is too ashamed. Sorry.

Greg

Does he have a copy of the test result?

yes. ok wait i find it

Greg

Please take a photo and send it if you find it

(Here I was sent liver function test results and the results of a liver scan. These showed elevated liver enzymes and liver cirrhosis. Also a prescription for Harvoni, even though no genotype test had been done.)

Okay Mary… those liver enzymes of your husband are a little high

But Sofosbuvir + Ledipasvir is not the best treatment option

Sofosbuvir + Daclatasvir is better. Sofosbuvir + Ledipasvir is only optimum for genotype 1. Because you do not know the genotype it is not the best.

If it will help you I will supply the medication for 15,000 pesos including delivery

ok thank you sir greg. my husband have very low energy always in the bed

we will save money first sir greg. thank you

SEP 18, 2019, 1:24 PM

Greg

Please send me an email Gregjefferys@outlook.com with your mailing address and phone number Also copies of the tests. I will send you the medicine. You can pay for the medicine when you have saved the money

wow that’s great.. youre a good man greg. im ashamed to you. its ok to you instalment. wow

you have a good heart  your saving the life of us

SEP 18, 2019, 9:50 PM

sir greg have a good day i already send a email to you. i have save money here 4,000 peso. i hope its ok to you. god bless always sir greg

I will be in Cebu later this year… when I am there you can pay me what you can afford

what month sir greg

Greg

November

next month huh so early. i try my my very best sir greg

i will.ask some help of my relatives.

to donate me. to my med in order to.pay you

i have give you my word of honor sir greg

Greg

No pressure from me Just what amount is comfortable

 thank you so much sir greg . try to visit davao city sir greg my husband will tour guide you here

many tourist spot here.

il just wait your message sir greg if you send the med. thank you. longlive sir

sir greg message me if you send the med. thank you

o ni reply ni ok ra daw. nalooy man cya sa akoa. ako gi engnan na ngayo rako tabang sa akng mga relatives para maka palit tambal. lisod kau ko.

search lng cya fb. naka award na cya. pina ka barato og efective nga tambal sa hep.c worlwide

ok na c sir greg sir greg sister dile atik iyaha

SEP 19, 2019, 10:30 AM

Greg

Have you sent the mailing address to my email yet?

yes sir greg i already sent you a email my addres

Greg

my sister in cebu city sir greg she wil help me to pay my med to paid in one year

Greg

SEP 19, 2019, 3:45 PM

sir greg may i ask the med you will send to me. is it enough to cured my hep c. we are only poor sir greg

SEP 19, 2019, 7:00 PM

Greg

This will be 12 weeks treatment with Sofosbuvir and Daclatasvir. Which is the best option for your husband and will give him a 98% chance of a cure

thank you sir greg. longlive to you. mabuhay po

My husband feel now always low energy. always in bed. bleeding gums. your an angel sir greg .thank you for helping my husband to be cured

im so exited he to be cured

Greg

I hope that those things will improve quickly I also had the bleeding gums and easy bruising

SEP 19, 2019, 10:21 PM

good day sir greg my full name Mary De Linoza my address #### zone ### sasa davao city philipines.

SEP 20, 2019, 9:52 AM

Greg

Please send me an email Gregjefferys@outlook.com with your full address

SEP 20, 2019, 11:40 AM

ok sir greg i already send now an email. complete name and addres. code.

SEP 22, 2019, 10:05 PM

hello sir greg. how are you? i hope youre in good health always.

Greg

Very good thanks

may i know sir greg what is the status of the med of mine..when its arrive? just asking. i hope.its ok.to you

OCT 15, 2019, 3:43 PM

sir greg have a day good to you. what is the name of cargo company will. deliver of medecine you sent to me. My husband feel so very tired now always in bed. back pain. thank you

He is feel he is slowly dying sir greg..thank you

OCT 15, 2019, 5:52 PM

sir. greg i track the tracking no. that you give you to me the package already here in the philipines. i will go to ems office tomorow. thank you

Greg

Please tell me when you receive it

ok sir i will take a picture the med when i already recieved and il send it to you. thank you. longlive to you sir greg

OCT 16, 2019, 3:32 PM

Greg

So in a small cardboard box 6 small bottles made it through the Filipino postal system to a humble home in Mindanao where a Filipino man was slowly dying of Hepatitis C

Sir greg i already recieve the medecine. thank you so much.

my sister from cebu city . who help me to pay the medicine shes asking how to sent the money. im for ever thankful to you my friend

My husband just finish drive taxi today

Greg

Please tell me how the treatment progresses I hope that there is improving health soon. It should be soon… Maybe within a week or so

ok sir greg i will tel you.

sir, greg we only can aford 15k instalment pls sir greg . we just credit the money coz were ashame to you pls

Greg

It’s not a problem

thank you so much. youre very good man. may god bless you and to your family. mabuhay.

i hope all man in this world like you have a good heart willing to help poor people like us

My husband will start. his treatment 1tablet sufos 1tablet dacla every morning 7am its ok sir greg

Greg

Morning is usually a good time

OCT 16, 2019, 10:00 PM

ok thank you so much sir greg

NOV 24, 2019, 11:36 PM

Greg

Hi Mary how is your husband going with taking the treatment? Is everything going well

I am flying to Cebu tomorrow

NOV 25, 2019, 12:33 PM

yes sir greg everything is going well. i will send message.my sister that you will be in cebu tomorow. have safe trip sir greg god bless

sir greg please send message to my sister yo yo if you already in cebu

NOV 25, 2019, 7:24 PM

Greg

I will… I am here in Cebu for 12 days so there is no rush

How are you? How is your husband ?

NOV 26, 2019, 12:00 AM

I am good sir greg. My husband improve much. no more gum bleeding. early wake up in the morning. Not stay in bed all day. but he have still backpain sir greg

praying he wil completely cured

NOV 26, 2019, 6:35 PM

Greg

THU 1:54 PM

thanks for helping me to get my husband meds sir greg. hope you enjoy your vacation.

I am glad to be able to help and I hope that your health will continue to improve

thank you sir greg

So I met Mary’s sister Yo Yo, a lovely vivacious woman in her 20’s,  in Cebu. It was a nice situation where I learned that Yo Yo was a nurse and fully understood the way things were for her family in Mindanao.

It was also very nice that she could knowledgeably report on improvements in her brother’s health.

It was also very interesting to hear Yo Yo’s perspective on health care in the Philippines.

Meeting Yo Yo in Cebu was a wonderful thing because it is very rare that I actually meet, face to face, anyone who I have helped

Yo Yo is the family’s main income earner and lent her sister’s family most of  the money for the treatment. However it was still very tough for the family because the mother had recently been diagnosed with a heart condition that required surgery. So as well as helping her sister’s family with the Hepatitis C treatment Yo Yo was also saving money to pay for heart surgery for her mother.

Filipinos are wonderful in the way they care and maintain family connections. The extended family is a vast and highly valued network of 2^nd 3^rd 4^th and 5^th cousins.  Family members support family members and even in the midst of poverty families will pool their meager resources to help each other where it is possible.

Sadly it is not always possible.

Over the past few years I have been helping Filipinos with Hepatitis C access affordable treatment for the disease and will continue to try to bring the price down to a level where even the poor can afford treatment. To bring the price down I need to be able to purchase a bulk amount of medicine. If I could raise the money to buy one thousand treatments I could reduce the price by more than 30%.

Next year I plan to start approaching some of the big philanthropic groups to a loan of about US$200,000 to try to turn the Hep C situation around in impoverished countries.

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