The World Health Organisation has issued its first-ever global treatment guidelines for hepatitis C, strongly recommending the use of new antivirals, i.e. Gilead Science's Sovaldi (sofosbuvir) and Johnson & Johnson's Olysio (simeprevir) but has added its voice to concerns about the eye-watering prices of the drugs.

The guidelines, launched ahead of the International Liver Congress in London, also provide advice on screening to tackle a chronic infection that affects 130-150 million people and results in 350,000-500 000 deaths a year. However, rather than just addressing screening and treatment, the WHO directly tackles the thorny issue of price, which has been thrust into the spotlight given that a 12-week course of Sovaldi costs $84,000 in the USA.

Peter Beyer, senior advisor for the Essential Medicines and Health Products Department at WHO, stated that HCV treatment "is currently unaffordable to most patients in need. The challenge now is to ensure that everyone who needs these drugs can access them".

He added that "experience has shown that a multi-pronged strategy is required to improve access to treatment, including creating demand for treatment. The development of WHO guidelines is a key step in this process".

Meantime, the drug-buying agency UNITAID, which is hosted by WHO and gets half of its finances come from a levy on air tickets, issued a statement saying that the recommendations "are very much welcome". However, it acknowledges that while "manufacturers are likely to offer the poorest countries the new HCV medicines at a heavily discounted price..pharmaceutical companies are unlikely to offer discounts to middle-income countries they regard as emerging markets".

UNITAID added that "finding those affected who are likely to develop severe illness is essential for building market intelligence to encourage more manufacturers to enter the market".  However, aside from the price of drugs, "screening and monitoring currently costs $300-1,400 per patient, out of reach for most middle-income country budgets".

Gilead has been looking at voluntary licences that will allow Indian drugmakers to manufacture and sell Sovaldi in around 60 lower-income countries in Africa and Asia for about $2,000 for a course of treatment. Last month, it offered to supply the drug, which offers very high cure rates, in Egypt for around $900.