About mapCrowd

Worldwide, an estimated 71 million people are chronically infected with the hepatitis C virus (HCV). Obtaining reliable, update-to-date information on HCV is a major challenge for health experts and HCV advocates. The quantity and quality of data on HCV prevalence, access to prevention tools, availability, and pricing of diagnostics and medicines, treatment uptake, and national HCV policies varies considerably across countries. Often, this information can be difficult to obtain due to poor surveillance systems, limited diagnostic capacities, weak infrastructure, and lack of political commitment or awareness. Particularly at the national level, sources for recent, consistently updated data are often scarce. Until now, there has been no centralized system for collecting and sharing this vital information with the international health community.

To address this lack of data and enhance advocacy efforts, Médecins du Monde (MdM) and Treatment Action Group (TAG) have launched mapCrowd, an online crowdsourcing platform designed to gather and publicize the most up-to-date country-level information on HCV. Providing free access to national, regional, and international data, mapCrowd allows users to draw visual comparisons between countries, using interactive graphs, tables, and maps. Users can download the mapCrowd database in Excel format for their own analysis. 

Topics covered by mapCrowd include:
  • General country information: human development and health indicators
  • Information on HCV epidemiology
  • Availability and prices of HCV diagnostics
  • Registration status, patent barriers, availability, and prices of HCV treatments
  • National HCV policies and treatment programs
  • Local organizations working on treatment access

Methodology

The data originate from a combination of field-based sources – from mapCrowders – and scientific publications. mapCrowd prioritizes data from mapCrowders, when available, then data from scientific publications.

Field-based sources
mapCrowd relies on a network of national HCV experts and advocates, or “mapCrowders,” who act as focal points for data collection. Most mapCrowders are affiliated with non-governmental organizations (NGOs). They are selected for their expertise in HCV advocacy and their capacity to obtain country-level information from a variety of sources.

Since mapCrowd was launched in February 2016, HCV experts and advocates are provided technical assistance and granted access to their respective country profile, upon review of their background and ability to gather relevant data. mapCrowders are then able to update online data on HCV at the national level according to their research and network. In some cases, respondents report that data is hard to obtain or only partially available (such as data on yearly national treatment uptake). Where possible, mapCrowders work with Ministries of Health to obtain the most up-to-date information and complete missing data.

As for January 2019, 46 countries have been fully or partially filled in by mapCrowders:
Algeria, Argentina, Australia, Belarus, Belgium, Brazil, Bulgaria, Cambodia, Cameroon, Canada, China, Cote d'Ivoire, Czech Republic, Egypt, France, Georgia, Germany, Greece, Guinea, Hungary, India, Indonesia, Iran, Ireland, Italy, Kazakhstan, Kenya, Lebanon, Malaysia, Morocco, Myanmar, Pakistan, Poland, Portugal, Romania, Russia, Spain, Switzerland, Slovak Republic, Tanzania, Thailand, Tunisia, Ukraine, United Kingdom, United States and Vietnam.

To supplement their contributions, mapCrowd also incorporates data gathered from a literature review of peer-reviewed medical journals, expert reports, and institutional research that are listed per topic below.

MapCrowd data sources

General remarks
  • MapCrowd covers 218 countries, 217 from the official World Bank list plus Taiwan.
  • ‘West Bank and Gaza’ has been renamed Palestine. Since April 2018, Swaziland has returned to its original name ‘Eswatini’.
  • All the prices are filled-in with the local currency by mapCrowders. Then the price is automatically converted into US$ according to the daily exchange rate through the API currency layer: https://currencylayer.com/.

 

0. GENERAL INFORMATION:
General remarks
This section is comprised of 13 questions divided into sub-sections: General and Health.
All the data of this section come from the World Bank Open Data website and updated yearly,(http://databank.worldbank.org/data/source/world-development-indicators#). When data are not available for the current year in a country, the most recent data are preferred in a maximum of 4 years, if not, “no data” is filled-in.

 

1. HCV EPIDEMIOLOGICAL DATA:
General remarks
This section is comprised of 6 questions. When there was no medium rate, an average has been calculated between the lowest rate and highest rates. This calculation applies to approximately 25 data and is indicated in the comment space linked to the data. The most recent data or data entered directly by a mapCrowder has been given priority over data from the scientific literature review. Data sources are given to the extent possible in the comment space corresponding to each data.

1.1 Estimated adult prevalence of HCV (antibody):
Overall (%)

 

People who inject drugs (PWID)
  • mapCrowders
  • L. Degenhardt, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global Health (2017) https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(17)30375-3/fulltext#seccestitle10.
  • Eastern Europe and Central Asia : Viral Hepatitis B and C in Eastern Europe and Central Asia: Civil Society Response to the Epidemic, update July 2017. http://aph.org.ua/wp-content/uploads/2016/07/2017eng.pdf.
  • United Nations Office on Drugs and Crime, World Drug Report 2018. Vienna: United Nations publication; https://www.unodc.org/wdr2018/index.htm

1.2 Estimated number of viremic adults:
Previously in the mapCrowd, the number of viremic adults per country was automatically calculated by applying the average approximation of 74% Chronic HCV among persons with HCV anti-bodies (in Micallef, J. M., Kaldor, J. M., & Dore, G. J. (2006). Spontaneous viral clearance following acute hepatitis C infection: A systematic review of longitudinal studies. Journal of Viral Hepatitis, 13(1), 34–41. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2893.2005.00651.x) to the estimated adult HCV anti-body (question 1.1).

Overall sources:
By now, mapCrowd integrates data from the study Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study made by Polaris Observatory HCV Collaborators and published in 2017 in the Lancet Gastroenterol Hepatol. 2017;2(3):161–76. https://www.thelancet.com/action/showPdf?pii=S2468-1253%2816%2930181-9.
This study provides data for 100 countries and is used by the WHO as the primary reference on this issue despite the following potential bias/cautions. For example, mapCrowd highlights that:
  • The Polaris Observatory is founded by the CDA Foundation (CDAF), a ‘non-profit organization that specializes in the study of complex and poorly-understood diseases in order to provide countries with the data and information to create and implement successful elimination strategies.’ The source of funding may influence the objectivity and quality of the data. The CDA Foundation has received grants from the CDC Foundation, John C Martin Foundation, The Association of State and Territorial Health Officials (ASTHO), Zeshan Foundation, Vaccine Impact Modeling Consortium, WHO WPRO, WHO Geneva, Swiss Federal Office of Public Health, Brazil MoH, Center for Disease Analysis, and private donors. CDA has received research funding from Gilead Sciences, AbbVie, & Intercept Pharma (see http://cdafound.org/content/hepsummit/Razavi%20-%20HCV%20&%20HBV%20global%
    20cascade%20of%20care%20180610.pdf
    ).
  • Polaris Observatory is only sharing updated data in countries/states where they are funded. As of January 2019, only hepatitis C data for China, Hong Kong, Taiwan and 5 US states are available online (http://cdafound.org/polaris-hepc-dashboard/).
  • Polaris’ data are conservative, not disaggregated according to key populations, and may significantly undercount key populations, such as people who use drugs, incarcerated and homeless people. People with a history of poor access to public and private health systems will be undercounted in estimates that rely primarily on individuals who do not face stigma or other barriers to care. 

 

People who inject drugs
  • mapCrowders
  • The average approximation is 74% prevalence of chronic HCV among persons with HCV antibodies (in Micallef, J. M., Kaldor, J. M., & Dore, G. J. (2006). Spontaneous viral clearance following acute hepatitis C infection: A systematic review of longitudinal studies. Journal of Viral Hepatitis, 13(1), 34–41. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2893.2005.00651.x)  was the source applied to the number of PWID with HCV antibodies when data was made available from Question 1.4.

1.3 Estimated adult prevalence of HIV:
Overall (%)
  • Most recent UNAIDS estimates.


People who inject drugs (%)

1.4 Estimated HCV prevalence among HIV-positive adults:
Overall (%)
  • mapCrowders

People who inject drugs (%)
  • mapCrowders

1.5 HCV genotypes distribution in general population:
  • mapCrowdersGower, E., Estes, C., Blach, S., Razavi-Shearer, K., & Razavi, H. (2014). Global epidemiology and genotype distribution of the hepatitis C virus infection. Journal Of Hepatology, 61(1), S45-S57. http://dx.doi.org/10.1016/j.jhep.2014.07.027.

 

1.6 Estimated number of people who inject drugs (PWID) in the country:
  • mapCrowders
  • United Nations Office on Drugs and Crime, World Drug Report 2018. Vienna: United Nations publication; https://www.unodc.org/wdr2018/index.htm

 

2. HCV TESTS AND DIAGNOSTICS:
  • mapCrowders

3. HCV TREATMENT:
3.1 Are the following medicines registered in the country?

In addition, to find your national body in charge of the regulation of drugs, a non-exhaustive list of Global Regulatory Authority Websites is available here: https://www.pda.org/scientific-and-regulatory-affairs/regulatory-resources/global-regulatory-authority-websites
And a less updated list of medicines regulatory authorities is published by the World Health Organisation: http://www.who.int/medicines/areas/quality_safety/regulation_legislation/list_mra_websites_nov2012.pdf


3.2 Are there any patents on the following medicines in the country?

3.4 Is there any initiative to overcome patents barriers and curb excessive prices in your country?
Data related to patent oppositions and compulsory licenses:

 

Data related to voluntary licenses: from the official list of territories/countries included in the license agreements from three pharmaceutical companies:
  • Gilead: 2017 amended & restated voluntary HCV license agreement (PDF): https://www.gilead.com/-/media/files/pdfs/other/form-ar-hcv-license-agmt-gild-11202017.pdf?la=en&hash=EA13A53F28CE66946255B7369B57EEFE  (p31).
  • Medicine Patent Pool license with Bristol Myer Squibb Licence Agreement on Daclatasvir, 2014: https://medicinespatentpool.org/uploads/2017/07/MPP-HCV-Sublicense-agreement-form-FINAL-Web-00000002.pdf (p32).
  • Medicine Patent Pool license with AbbVie on glecaprevir/pibrentasvir (G/P) November 2018: https://medicinespatentpool.org/uploads/2018/11/AbbVie-MPP-Executed-HCV-Agreement.pdf (exhibit A).

 

Availability & prices of HCV treatment

 

3.14 Are the following HIV drugs (ARV) available in your country?
  • mapCrowders

4. HCV POLICY:

Treatment Uptake

5. HCV ORGANIZATIONS:
  • mapCrowders

Acknowledgment

This website has been produced with the financial support of the French Development Agency (AFD). The ideas and opinions expressed do not necessarily represent those of AFD.







En poursuivant votre navigation sur ce site, vous acceptez l’utilisation de Cookies pour réaliser des statistiques de visites.