Dr. David Kershenobich

Dr. David Kershenobich

Director General, National Institute of Medical Sciences and Nutrition “Salvador Zubirán” (INCMNSZ)

“It is not a question of economic resources or pricing of the medicines or the budget of the government. Our responsibility as physicians is to develop innovative approaches of how to solve the problem. We know the disease is curable and we can prevent cirrhosis and liver cancer. About a quarter of cirrhosis or liver cancer cases are due to HCV in Mexico.Years ago we didn’t look for hepatitis because we didn’t have the medicines, but now we must test and treat. I hope the example of what we are doing in Mexico will help the Latin American region overcome the remaining hurdles in treating HCV,”

Photo of Dr. Kershenobich

 

Dr. Kershenobich has been a national leader in expanding access to life-saving hepatitis interventions for over 20 years. After co-founding the Mexican Liver Foundation (FUNDHEPA) in 1999, he lobbied the Minister of Health and the Parliament and succeeded in securing universal vaccination for hepatitis B among newborns in Mexico. The program has now been in place for over 20 years and has resulted in the vaccination of approximately 40 million children.

Once oral DAA´s became available for hepatitis C (HCV), Dr. Kershenobich tirelessly advocated for the elimination of age and fibrosis restrictions limiting access to treatment. Once restrictions were lifted, he continued to fight for equitable and expanded treatment access- pressing for further negotiations to consolidate procurement of HCV treatment across key government authorities, bringing together stakeholders to model the required treatment levels needed for elimination and initiating discussions on affordable drug pricing with pharmaceutical companies.

These efforts ultimately led to bold and innovative HBV and HCV programmatic approaches in Mexico. One example is the HCV treatment financing plan where the government pays the pharmaceutical companies a fixed price for a certain number of HCV treatments, but once the number is surpassed additional treatments are free of charge. This approach incentives providers to treat as many patients as possible in a given year. The Mexico hepatitis C elimination was initiated in October 2019 and provides access to treatment, regardless if the patient has social security insurance or not. Approximately 12,000 patients have received treatment to date as Mexico works to eliminate HCV by 2030.

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