Uncategorised

Charities file joint hepatitis C drug patent challenge

Doctors of the World is today filing a patent challenge on a hepatitis C drug with the European Patent Office (EPO) in an attempt to bring down the price and increase access to treatment that can cure the disease. The drug, sofosbuvir (brand name Sovaldi), is made by the pharmaceutical company Gilead.

We have joined MSF, Just Treat and 30 other organisations in 17 countries in jointly filing a patent challenge on Gilead’s monopoly on the life-saving medicine.

Sofosbuvir is an oral ‘direct-acting antiviral’. It is part of most hepatitis C combination treatments and has led to a dramatic increase in cure rates.

The price, however, is also dramatic. In the UK the list price is £34,983 for a standard course. While the final price paid by NHS England is confidential it’s thought to be at least £20,000. Studies show that it costs 80p to make each pill.

Even at a price per person of £20,000 it would cost a staggering £4.3 billion to cure everyone in the UK of the disease.

Countries where Gilead retains monopoly control over sofosbuvir cannot import or produce generic versions.

For many people living in some middle-income countries, Gilead’s restrictive voluntary licensing agreements keep sofosbuvir out of reach for people and their governments.

In the UK, 215,000 people are living with hepatitis C. The NHS has capped treatment at 10,000 people per year. Around the world, 80 million people are infected.

Nick Harvey, head of communications at DOTW, said: “Nobody is saying that pharmaceutical companies shouldn’t be making a profit, just not extortionate ones.

“We are in a situation where 350,000 people around the world are dying every year from hepatitis C completely unnecessarily because there is a cure.

“Life-saving medicine is taking a back seat to profits and that shouldn’t be the case.”

Patent challenges or oppositions can remove or shorten the length of a patent and enable the robust generic competition needed to dramatically reduce prices.

Key patents on sofosbuvir have already been revoked in China and Ukraine, and decisions are pending in other countries, including Argentina, India, Brazil, Russia and Thailand.

If the patent challenge is successful, it could accelerate the availability of affordable generic versions of sofosbuvir in Europe.

It would also encourage all countries to take measures to open up access to affordable generic versions of sofosbuvir by either negotiating better deals with Gilead now, and/or taking actions including issuing compulsory licences to import or manufacture more affordable generics.

For media enquiries contact Nick Harvey on nharvey@doctorsoftheworld.org.UK or 0207 167 5789.

Pregnant women frightened away from healthcare in the UK

By Nick Harvey

Earlier this year, Sagarika* stumbled into our Bethnal Green clinic breathily heavily. She was in labour and she was terrified. As an undocumented migrant, she’d been too afraid to see a doctor during her pregnancy – she’d had no antenatal scans and she had no idea if the baby she would soon deliver was healthy.

At our specialist women and children’s clinic in London, we regularly see pregnant women who aren’t getting the ante-natal care they desperately need, because they fear being arrested or being sent a huge hospital bill that they can’t pay. The Guardian has today published an in-depth piece about our clinic and its work.

“The NHS says antenatal care should always be provided, but we regularly see women who’ve been put off getting that care, which puts both mother and child at risk,” says Phil Murwill, who runs Doctors of the World’s London clinic. “We see women who are 40 weeks pregnant turning up at our clinic having received no antenatal care at all. This includes extremely vulnerable women such as survivors of trafficking and sexual violence.”

Another of our recent patients is Li*, who fled to the UK from China five years ago after facing persecution for being a Christian. After she became pregnant, her local GP surgery wrongly turned her away because she didn’t have documents to prove her address – everyone in the UK has the right to see a GP for free, regardless of their immigration status, income, or documents.

Luckily, Li came to our women and children’s clinic, where we helped her register with a GP and get antenatal care. She gave birth to a healthy baby last year. But we couldn’t stop her receiving a bill for more than £5,000 shortly before she’d even had her baby.

“It was so scary,” Li says. “When you’re a single mum and you see a bill like that, you just panic.”

Undocumented migrants are charged 150% of the usual NHS fee, which means that a complications-free pregnancy costs around £5,000-£7,000. If there are any complications the cost can be many times that amount.

“The women we see get no support from the state, so how are they supposed to pay?” says Anna Miller, Doctors of the World UK’s policy lead. “These bills not only cause extreme stress and deter women from seeking healthcare, women are also often forced into illegal or exploitative work to try to pay them.”

Doctors of the World has seen billing letters to pregnant women that threaten to discontinue antenatal care if the patient does not pay an upfront deposit of £6,500. These letters are clear breach of NHS guidelines, which state that no woman should be denied access to maternity services due to charging issues.

We also regularly see letters that threaten to report pregnant patients to the Home Office if they can’t pay. Many pregnant women are already too afraid to see a GP or go to hospital because they fear that immigration officers could use these institutions to track them down.

The UK government recently admitted that an MOU had been signed between NHS Digital and the Home Office agreeing to share patient information such as addresses. Last month, we shared exclusive evidence with Buzzfeed showing that the Home Office has also been contacting GPs directly to get patient information.

This hostile environment for migrants led to a terrified Sagarika coming to Doctors of the World in labour. Our staff put her in a taxi to the nearest hospital and four hours later she gave birth to a healthy boy.

Sagarika was one of the lucky ones – we have no idea how many other women in the UK are choosing not to go to hospital and are giving birth at home, alone, with all the risks that entails. And Sagarika will soon no doubt receive the bill for her son’s delivery.

* Names have been changed to protect our patients’ identities

If you would like to support our vital work in the UK and around the world, please text “doctor” to 70660 to donate £10

We condemn the UK bypassing GPs to get patients’ data

The UK government has found a new way to obtain vulnerable patients’ private details without even asking their GP, Buzzfeed News has reported today in an investigative story that uses exclusive evidence and interviews from Doctors of the World.

We totally oppose the government asking NHS Digital, the body that stores patients’ data, for people’s home addresses and other private information as part of an immigration crackdown. This exploits the confidential relationship between a doctor and their patient.

“This could be the start of a slippery slope – if the NHS is already sharing vulnerable people’s private data with the government, there’s no guarantee this practice will not spread to other patients,” says Leigh Daynes, the executive director of Doctors of the World UK. “This is not a niche issue, such a huge erosion of rights affects us all.”

At our UK clinics, we already regularly see people who are too scared to see a doctor in case their private details are shared with the government and used against them. A Filipino woman recently came to our clinic in east London and told us she hadn’t gone to her hospital appointment – even though she needed to be tested for breast cancer.

The UK government has for many years sent requests to NHS data departments when trying to track down undocumented migrants. But previously the government often had to write directly to GPs to request a patient’s address – and these doctors were a potential hurdle when they chose to protect their patient’s privacy and refused to share information.

We received one such letter in 2016 and another NHS GP has shared with us three similar letters that they have received. We refused to hand over patient information, as did the other GP who contacted us.

However, on 24 January the government disclosed that it now asks NHS Digital to share patients’ home addresses. This extension could mean that in many instances that the GP is effectively bypassed and never contacted.

Making people too afraid to see a doctor causes a range of serious problems. When GPs spot and treat problems early, this helps patients in need recover quickly, stops illnesses from spreading, and saves the NHS money further down the line by cutting the need for costly emergency treatment.

“We’ve had to start to tell patients at our clinics that their data is no longer private and some just walk out,” says Phil Murwill, who runs Doctors of the World’s clinic in east London. “The long-term impacts of this could be huge, including more people dying at home and more women giving birth at home alone, with all the risks that entails.”

The government’s latest move is part of a wider aim to create a “hostile environment” for undocumented migrants. In December, a data-sharing deal was also disclosed between the Home Office, the government department responsible for immigration, and the Department of Education. Under the agreement, education officials could share the personal details of up to 1,500 schoolchildren a month, the Guardian has reported.

Kingsley Manning, the former head of NHS Digital, spoke out on BBC Radio 4 last week about the government pressuring him to share patient data despite his objections.

“[The NHS] is a safe haven for your data…except if you’re an immigrant and except if the Home Office wants it,” he said.

“There’s no right of appeal, there’s no oversight, and there’s no transparency.”

** If you would like to support our vital work in the UK and around the world, please text “doctor” to 70660 to donate £10 **

We oppose upfront ID checks and charges for vulnerable NHS patients

The UK government has announced that, from April 2017, there will be new laws to make hospitals carry out upfront ID checks and fees for many migrant patients. The rules apply to people seeking non-urgent hospital treatment, such as hip operations or cataract removals.

Doctors of the World strongly opposes this move – it will deter the most vulnerable people in our society from going to hospital, many doctors are against it, and it is unclear how much money it will save the NHS.

We believe that people who can afford to pay for their healthcare should do so, but hospitals should not have rules that could shut out people in need. Many excluded people in the UK, such as asylum seekers and trafficking survivors, also do not have ID and address documents. This also applies to some British people such as the homeless, the destitute, and the elderly.

“At our clinics, we already see heavily pregnant women, cancer sufferers, and people with ill children who are too scared to see a doctor. Hospitals should be reducing the barriers these people face, not putting up more,” said Leigh Daynes, executive director of Doctors of the World UK.

There are already NHS guidelines that ask hospitals to charge patients living outside the European Economic Area for non-urgent care, but the guidelines are not legally binding.

Many doctors are also against this move. Medics don’t want to turn away ill people or take on extra admin work when NHS staff are already overstretched. Many medics said last year that they would boycott mandatory ID checks for hospital patients.

“Doctors just want to treat the person in front of them. Asking patients to disclose their immigration status straightaway would create a stigma around it – and the last thing I want is for my patients to feel afraid or unwelcome,” said Lucinda Hiam, an NHS doctor who volunteers at one of our clinics in London.

The government has set a target of saving £500m a year by charging visitors to the UK and migrants for some medical treatment. However, the government has still not said whether collecting charges will actually cost the NHS more money, in terms of staff time and admin work, than it saves.

Treating people when their illness is still non-urgent also saves the NHS money down the line – many patients may wait until they need expensive emergency care at A&E. This could all cost hospitals more in the long run than they recoup. “When people aren’t treated quickly and efficiently, it can cause risks to individual health, public health risks – and push up future costs for the NHS,” says Dr Hiam.

The £500m that the government hopes to save each year by charging migrants is a drop in the ocean compared to the £22bn of savings that NHS England is trying to find by 2020.

David Lammy, a Labour MP, tweeted soon after the government’s latest announcement that it was “avoiding an honest conversation” about a dire shortage of funding for the NHS by trying to score “quick wins” on charging migrants.

** If you would like to support our vital work in the UK and around the world, please text “doctor” to 70660 to donate £10 **

 

The UK must not use the NHS as an anti-immigration tool

Last month, a 44-year-old woman at one of our London clinics burst into tears. The Filipino patient was terrified that, if she registered with a doctor, her personal data would be passed on to immigration authorities.

This was far from a one-off. At our UK clinics, we regularly see seriously ill people who are too scared to see a doctor even though they have a legal right to do so.

The UK government has for many years sent information requests to the NHS when trying to track down undocumented migrants, and on 24 January it disclosed that these requests had been extended to ask for a patient’s home address and GP details. On 1 February a former head of NHS Digital, the body that stores patient data, spoke out about being pressured by the government to share patient information.

Doctors of the World strongly condemns the government using the NHS as an anti-immigration tool. This exploits the confidential relationship between a doctor and their patient. It also leads to extremely vulnerable people, such as pregnant women, parents with young children, and sufferers of serious illnesses, being too afraid to see a doctor.

“We totally oppose the Home Office using the NHS as part of its witch-hunt for undocumented migrants,” says Leigh Daynes, executive director of Doctors of the World UK. “Doctors are not border guards – healthcare and immigration are totally separate matters.”

Most doctors do not want to play any role in immigration enforcement. They simply want to treat people in need, regardless of their race, religion, nationality, or any other such factor.

“Patients see their GP as neutral and unconnected to the government – and this trust matters,” says Peter Gough, an NHS GP who volunteers at one of our London clinics. “If patients don’t open up to us, it’s harder to diagnose their problems and treat them.”

Home Office requests for patient data have risen threefold since 2014 as Theresa May’s government has stepped up efforts to create a “hostile environment” for undocumented migrants, the Guardian reported this week. This push includes a pilot scheme currently underway at 20 NHS hospitals, whereby patients must show a passport to get treatment, the Independent reported last week.

We find these moves particularly shocking because everyone in the UK has the right to see a GP and use hospitals’ emergency departments for free, regardless of immigration status. When GPs spot and treat problems early, this saves patients distress and ill-health, stops diseases from spreading, and saves the NHS money further down the line. Anything that deters people from seeing a doctor carries health risks for all of us.

In the UK, the majority of Doctors of the World’s patients are undocumented migrants, who have lived in the UK for six years on average before seeking a doctor’s help. A fifth of our patients have said they are afraid to see a doctor for fear of arrest.

“Many of the people we see at our clinic are desperate and frightened – we often see victims of trafficking and torture,” says Dr. Gough. “The threat of making their details known to the Home Office will deter many vulnerable people from going to the GP, even though they have every right to go. Many might instead simply disappear.”

** If you would like to support our vital work in the UK and around the world, please text “doctor” to 70660 to donate £10 **

This blog was originally published on 25 January 2017 and updated on 1 February 2017.

How healthcare bills impact UK’s refugees and migrants

By Kalina Shah

Many vulnerable migrants, including survivors of torture, trafficking, slavery, and abuse, find it impossible to access mainstream health services. Doctors of the World UK provides these excluded groups with support and treatment at our clinics in Bethnal Green and Brighton, as well as our pop-up clinics.

Everyone, regardless of their immigration status or income, is entitled to free primary healthcare such as initial GP and nurse consultations. Other services everyone can access for free include Accident & Emergency (A&E) treatment, the diagnosis and treatment of infectious and sexually transmitted diseases, family planning services, and the treatment of conditions caused by torture, domestic violence, trafficking or female genital mutilation.

But many excluded people, especially undocumented migrants (people without immigration papers), are wrongly turned away from GP practices as they are asked to provide documents they simply do not have – such as passports, driving licenses, utility bills or bank statements. Around four out of every five patients Doctors of the World sees at its London clinic are not able to register with the GP despite being fully entitled. This is despite clear NHS England guidelines stating that GP practices are not required to ask for proof of identification or address from patients wishing to register.

In short: GP practices should never refuse a patient who is not able to provide such documentation.

With regard to secondary healthcare, UK citizens and anyone who has been granted indefinite leave to remain are exempt from charges as are people who have an asylum claim in process (including appeals), and failed asylum seekers in receipt of section 95, section 4(2) or section 21 support. Many of our destitute patients do not fall under these categories and are presented with an extortionate bill by the hospital. If a bill in excess of £500 is not paid within two months, the hospital must inform the Home Office, the government department responsible for immigration.

This is why many of the people who come to Doctors of the World’s clinics are reluctant to attend hospital appointments. This was certainly the case for Lucy*, 22, from China, who came to the clinic when she was three months pregnant and very unwell. She was too afraid to see a doctor and had to be sent to A&E. We helped Lucy register with a GP and receive antenatal care, but the bill she received from the hospital has caused Lucy a great deal of stress as she has no recourse to public funds and has a limited support network to help with the costs.

Sadly, the UK government has consulted on also charging overseas visitors and migrants for primary care services. Although the details of what the charges may entail are unclear, the proposals included charging for A&E, ambulance services, dental and ophthalmic services.

Extending charges will only further deter vulnerable groups from accessing vital health services and risks costing the NHS more by dissuading people from accessing healthcare quickly – for many health problems, the longer you leave them, the worse and more expensive to treat they become.

It is not yet clear what charges the Department of Health will introduce, but they are likely to have a huge impact on many already vulnerable people across the UK.

*Not her real name

** If you would like to support our vital work in the UK and around the world, please text “doctor” to 70660 to donate £10 **

Video: Greece’s harsh winter puts refugees at huge risk

This video clip shows the shocking winter living conditions at Moria refugee camp on the Greek island of Lesvos.

As of 10 January in Moria, hundreds of men, women, and children were still sleeping in cold tents as snow continued for the fourth day. Greece’s government is sending a naval ship to Lesvos to house some of the camp’s residents and is also rushing to transfer people to hotels, Reuters has reported.

Doctors of the World works in Moria and several camps across Greece. Our team in Moria is providing medical care and essential items, such as sleeping bags and warm clothes, for those in need.

Last month, we were one of the first charities to warn that moves to prepare Greece’s refugee camps for the tough winter ahead were not moving quickly enough, creating huge health risks for refugees and migrants.

An estimated 62,000 migrants and refugees have been stranded in Greece, the Guardian has reported, after other European countries closed their borders last year.

“The only thing we could do when the weather is so cold is to light fires,” says Ahmed, a refugee from A’zaz, Syria, who now lives at Redestos camp, a warehouse in Northern Greece. “It is dangerous and spreads smoke. So we lit fires outside. But when we went back inside it was still too cold to sleep, so we had to light fires inside as well. We have never seen living conditions so bad. We did not think we would be left this way.”

Doctors of the World has called on the EU, the UN, and Greece’s government to work faster and harder to get refugees out of these terrible conditions. We also believe that other European countries must help Greece by taking in their fair share of refugees. Everyone deserves a warm place to stay during the winter.

The video clip was shot by Philippa Kempson, a Lesvos resident who has been helping give aid to the island’s refugees since 2015.

** If you would like to support our vital work in Greece and around the world, please text “doctor” to 70660 to donate £10 **

Video: Thank you to all our 2016 supporters!

Doctors of the World gave vital medical aid to tens of thousands of vulnerable people in 2016 – and we couldn’t have done this without you! Your donations and time, as well as your public support at events and on social media, make our work possible.

Our patients, volunteers and staff have made a video message to say a huge thank you to everyone who supported us in 2016. We hope you like it.

We’re looking forward to continuing our important work in 2017 – and beyond.

** If you would like to support our vital work around the world, please text “doctor” to 70660 to donate £10 **

The People’s Convoy sets off with medical supplies for Syria

Rola Hallam, a British-Syrian NHS doctor in London, was horrified last month when the last children’s hospital in the city of Aleppo was destroyed.

“I was devastated. It broke my heart,” says Rola, who has devoted much of her time in recent years to helping set up hospitals in Syria. “And so I wanted to find a way to do something tangible for Syrians and also to say ‘We are here with you.’ Syrians feel so abandoned right now.”

Rola soon came up with an idea: The People’s Convoy, a crowd-funded project that will send trucks of desperately needed medical supplies across Europe to a children’s hospital just outside the city of Aleppo. The project will give a lifeline to the last functioning children’s hospital in Aleppo governorate, which is home to Aleppo city. The hospital expects to use the supplies to treat over 5000 children per month.

The convoy, which will drive items such as stethoscopes and examination tables across 10 countries, will set off from London on 17 December. A coalition of NGOs, including Doctors Under Fire, The Syria Campaign, and Hand in Hand for Syria, have organised the project.

Syria’s hospitals and medics have been repeatedly targeted since the country’s brutal civil war started in 2011. There have been at least 382 attacks on medical facilities since the conflict began and the vast majority have been carried out by Syria’s government, according to Physicians for Human Rights. Doctors still working in the besieged Aleppo city risk being jailed or killed, the Guardian reported this week.

“Syria’s conflict is characterised by the wilful destruction of the country’s health system. This has to stop,” says Leigh Daynes, executive director of Doctors of the World UK.

The conflict has also sparked a huge increase in people who need medical care and a huge shortage of essential drugs and equipment. Around 11.5 million Syrians need healthcare, according to the UN.

“There are pregnant women delivering children on their kitchen floor – if they even have a kitchen floor anymore.There are no antibiotics for treating childhood illnesses, there are no anaesthetics for performing surgeries,” says Rola. “It’s like going back to the dark ages.”

Once the convoy reaches the Turkey-Syria border, the medical supplies will be handed over to the Independent Doctors Association, which works on the ground in Syria and ran the children’s hospital that was destroyed last month. The campaign has raised almost £103,000 so far, surpassing its initial target of £91,400 in just 10 days.

Rola hopes the People’s Convoy can provide a beacon of hope. “I’m a doctor and my passion is providing access to healthcare – I think it’s a human right,” she says.

The People’s Convoy will begin its journey at Chelsea and Westminster Hospital in London at midday on Saturday 17 December. There will also be a vigil to show solidarity with doctors and nurses in Syria in London’s parliament Square at 2pm.

Photo credit: The People’s Convoy.

Christmas campaign: Our volunteers share stories of working with refugees

As part of our highly successful Christmas campaign, we’ve done a series of mini-interviews with the brave staff and volunteers who help refugees and displaced people from the Middle East at our clinics.

Our first interview is with Aaminah Verity, a doctor from London who has volunteered for us in Greece and Slovenia, where we run projects that treat many refugees.

“In Greece, I dealt with seven psychiatric emergencies in less than three months. We were treating refugees from the Middle East who were processing everything they’d been through and were showing acutely psychotic symptoms,” says Aaminah.

“One woman tried to commit suicide three times. Every person I met had lost someone they loved.”

When Aaminah volunteered for us on the Greek island of Chios, where people would arrive on dinghies from nearby Turkey to seek refuge in Europe, she saw patients aged between five months and 84 years.

She also provided medical consultations and care for pregnant women and patients who were disabled, including a 13-year-old boy in a wheelchair. You can watch a video about her time in Chios below:

“We were using infrared thermometers and when we put them on children’s foreheads we were shocked to see them scream and drop to the floor. We realised that it was making them think of a gun to the head,” Aaminah says of her time in Greece. “We had to demonstrate by putting the thermometers on our own heads first to calm them down.”

Our Christmas campaign urges people to consider the realities of the Middle East – to highlight these realities, we’ve launched a set of alternative cards that juxtapose vintage nativity scenes with modern photographs of the region’s conflict zones.

We’ve been delighted by the positive response to these cards, which have attracted customers from around the world and have been covered by outlets including the BBC, CNN and Al Jazeera. You can buy the cards here and every sale will help us continue our vital work in the Middle East.

We will publish the rest of this series of interviews on social media over the next fortnight. Please follow us on Facebook and Twitter.

Petition urging the PM to authorise air bridges to Aleppo

With winter approaching, almost a million Syrians are living under siege conditions, including an estimated 500,000 children.

As a charity that runs medical clinics across the Middle East, including in Syria, we are launching a petition to urge Prime Minister Theresa May to agree to air bridges that would allow desperately needed aid to get into Aleppo, as demanded by over 200 MPs this week.

Establishing an air bridge, rather than dropping aid from planes, means delivering aid via helicopter to airports, highway landing strips, or unimproved airfields. It’s not ideal but in these critical times it’s a better way of trying to get aid where it’s needed most.

Over 11.5 million people need healthcare in Syria but over half of the country’s public hospitals and almost half of its healthcare centres are closed or partially functioning.

Please stand up for those stuck in Aleppo. Sign our petition calling on our Prime Minister Theresa May to use her power and intervene.

We really hope to build on the momentum created by our hugely successful Christmas cards which contrast nativity scenes with modern images of the war-torn Middle East. The first batch sold out within 48 hours and we’ve had to reprint thousands more.

A big thank you to everyone who’s bought cards already. If you haven’t already you can still buy them here.