What is it?
The World Health Organisation has listed viral hepatitis as a major public health problem throughout the world and particularly in India. “... it is a serious health concern in India, with over a crore people suffering from hepatitis C. This is six times the number of HIV/AIDS patients,” according to . Poonam Khetrapal Singh, WHO regional director for southeast Asia.
A WHO release says hepatitis is preventable and treatable but remains an acute public health challenge globally and in the southeast Asia region.
Viral hepatitis kills approximately 3,50,000 people every year in the southeast Asia region and is responsible for more deaths than HIV and malaria put together. Among communicable diseases, it is second only to tuberculosis as a major cause of death. Globally, and in the region, the number of deaths due to viral hepatitis is increasing. “There is a need for immediate and urgent action to arrest the spread of hepatitis. In the southeast Asia region, viral hepatitis is driving up the rates of liver cancer and cirrhosis, and is causing premature death and disease with over 100 million people chronically infected with hepatitis B and C,” Dr. Singh said.
The Union Health Ministry’s National Programme for Control of Viral Hepatitis for 2018-19, with a budget of ₹600 crore for the next three years, hopes to screen the vulnerable population and provide free treatment where needed. This anti-viral treatment costs $63,000-$94,000 in the U.S. and Europe.
How did it come about?
The WHO says these high numbers are unacceptable as there is an effective vaccine and treatment for hepatitis B, and over 90% of the people with hepatitis C can be cured. “The Indian government’s plan stems from the understanding that 95% of the people with chronic hepatitis do not know they have been infected and less than 1% have access to treatment,” said a Health Ministry official.
“Hepatitis A virus and hepatitis E virus are responsible for sporadic infections and the epidemics of acute viral hepatitis. Hepatitis B virus and hepatitis C virus predominantly spread through the parental route and are notorious for causing chronic hepatitis, which can lead to grave complications, including cirrhosis of liver,” said Prof. Anil Arora, director, Institute of Liver, Gastroenterology and Pancreatic Biliary Sciences, Sir Ganga Ram Hospital.
Hepatitis C is caused by a blood-borne virus, which affects the liver. It could spread through the use of injectable drugs, unsafe injection practices, unsafe health care, and transfusion of unscreened blood and blood products. However, unlike hepatitis B, it is not sexually transmitted. There is no known vaccine for hepatitis C.
Why does it matter?
The National Hepatitis Policy will translate into better surveillance and detection of water and blood-borne hepatitis viral infections in various regions. The government will set up screening laboratories and provide trained manpower, an urgent need for India, according to Prof. Arora. “The state-of-the-art laboratories, drugs and diagnostic equipment and regional testing centres will be the foot soldiers in this march against hepatitis.”
Doctors say water and blood-borne viral hepatitis is an important public health issue in India, and under the programme, the availability of safe and potable water, early screening, vaccination and prevention of misuse of disposable needles and syringes will help to eliminate treatable viral hepatitis.
What next?
Meticulous screening, effective vaccination and easy availability of the newly discovered drugs at a reasonable price will help to make India free of viral hepatitis by 2030, said Prof. Arora. This coincides with the adoption by the WHO of the Global Health Sector Strategy for hepatitis that calls for eliminating the disease by 2030.
