DGHI Faculty Leading Projects Funded by Astra Zeneca and Johnson & Johnson

Hepatitis B virions

Digitally-colorized transmission electron micrograph image of hepatitis B virions

Published September 22, 2015, last updated on June 3, 2020 under Research News

Duke Kunshan University (DKU) is partnering with Duke Global Health Institute (DGHI) and the Development Research Center of the State Council (DRC), a policy think tank within China’s central government, on Chinese health policy projects funded by the pharmaceutical companies Astra Zeneca and Johnson & Johnson.

Astra Zeneca Supporting Investigation into Barriers to Hepatitis Care in China

Astra Zeneca has awarded DKU and DGHI 400,000 Chinese Yuan (approximately $63,000 USD) to identify obstacles in the diagnosis and treatment of hepatitis B and C, including the high cost of caring for these diseases, and make policy recommendations based on their findings.  The three partners will be looking at these issues from both the patient and provider perspectives.

Why Focus on Hepatitis?

Hepatitis is widespread in China, with 93 million people chronically infected with hepatitis B and 10 million people with hepatitis C. Despite the high instance of hepatitis, most are not aware of their infection and only a small percentage of those diagnosed—less than five percent—are effectively treated. If left untreated, hepatitis can lead to cirrhosis and liver cancer. Half of the global burden of new liver cancers and deaths due to liver cancer occur in China.

Most Chinese people under age 20 have been vaccinated against hepatitis B. For those who become infected—mostly older, non-vaccinated individuals—drugs are available to control, but not cure, the infection. While there’s no hepatitis C vaccine, there is a curative drug; however, its high cost makes it inaccessible to most people living in low- and middle-income countries.   

Significance of the Astra Zeneca Study

The World Health Organization has established guidelines and policy recommendations for the diagnosis and treatment of hepatitis B and hepatitis C, but this study aims to develop recommendations specific to China.

Study lead Shenglan Tang, professor of medicine and global health, notes, “Different countries have different contexts. We need to ensure that we offer practical policy recommendations that will meet China’s unique needs.”

Tang also sees the low diagnosis and treatment rates as an implementation problem. “Effective drugs alone won’t solve this problem. Take tuberculosis, for example: we’ve had TB antibiotics for nearly 50 years, and it’s still a public health issue in low- and middle-income countries. We need to identify the reasons patients cannot access care.”

Johnson & Johnson Project Will Address Pharmaceutical Policy in China

Earlier this year, Johnson & Johnson established a Memorandum of Understanding with the DRC, awarding them three million Chinese Yuan (approximately $473,000 USD) over three years. In each of the three years, they will undertake a new policy project in collaboration with DGHI and DKU. 

This year, the project team will conduct a study on pharmaceutical policy in China. The Chinese pharmaceutical industry is huge, with drugs comprising 40 percent of China’s health expenditures. The overabundance of small and mid-sized pharmaceutical manufacturers and “middle man” distributors have led to problems such as low-quality drugs and high mark-up rates. 

To address these and other problems in the pharmaceutical industry, the Chinese government has engaged DGHI and DKU to assist them in exploring international best practices in pricing, regulations, and purchasing within the pharmaceutical sector and how those practices could be applied to China.

The project team has hired international consultants to execute case studies on the pharmaceutical industries in India, Thailand, Australia, Germany and the United States. The DGHI and DKU collaborators will be responsible for synthesizing pharmaceutical practices in the case study countries and making policy recommendations, while the DRC will concurrently study the problems in the Chinese pharmaceutical industry and the factors associated with these issues. 

Jeffrey Moe, global health professor, and Shenglan Tang will lead the DGHI and DKU contingent.

Effective drugs alone won’t solve this problem. Take tuberculosis, for example: we’ve had TB antibiotics for nearly 50 years, and it’s still a public health issue in low- and middle-income countries. We need to identify the reasons patients cannot access care.

Shenglan Tang, medicine and global health professor