Delhi resident Manitosh Ghildiyal said it has been a week of back and forth.
Ghildiyal, who works with The Delhi Network of Positive People (a network of people living with HIV), said since last Tuesday, his group has been demanding that suspected and confirmed Hepatitis C patients receive tests and treatment from the government. Under the government’s national action plan for combating viral hepatitis launched in 2019, tests and antiviral drugs for Hepatitis C, and lifelong treatment for Hepatitis B is to be provided free by the government. Early diagnosis to prevent worsening of their condition has been emphasized by the government.
On ground, however, there has been a disruption of services. “Since February, the antibody tests for Hepatitis C (first step in diagnosing the disease, after which a RT-PCR test is done for confirmation) are not being done by the Delhi government,” said Ghildiyal, who pointed out that several suspected persons need the antibody test before their diagnosis for the viral Hepatitis C can be confirmed. The programme has been hit due to the health department’s COVID-19 priorities, and those who can’t afford the tests have been hit the hardest, activists said.
On July 28, as the world, and India, celebrated World Hepatitis Day, a section of patients couldn’t even get a basic test to diagnose their condition. “After a lot of back and forth, the officials at Delhi’s LNJP Hospital (model treatment centre for viral hepatitis) invited about 30 patients to the hospital and promised a screening test for them, today. However, none of them received it despite having reached at the designated time in the morning. All they did was wait all day,” said Ghildiyal, who has been raising the issue with the authorities.
For six months now, not a single new person has been put on Hepatitis C treatment, he said. “Health officials say they are busy and engaged in COVID-19 duty. We fail to understand that despite the fact that India has approximately 8-12 million HCV infections with about 96,000 deaths per year, is the government asking us to give up our lives so that Delhi, and the rest of the country, can deal with the pandemic” the group said in a press statement. Though the basic tests and treatment for viral hepatitis is cheap, many, say activists, can’t afford even that and need government support to combat the disease.
Health activists said the disruption of the viral hepatitis programme had been observed from several states across the country. RT-PCR machines in the country were being used for COVID diagnosis, and in states such as Manipur, where samples were being transported out of the state, disruption of transport services had meant that those samples couldn't be sent for testing.
According to the WHO, there are five main strains of the hepatitis virus—A, B, C, D and E. Of these, Hepatitis B and C are the most common cause of deaths, with 1.3 million lives lost each year.
In India, four crore people are suffering from Hepatitis B, and almost 1.2 crore people suffer from Hepatitis C. Taking into account the rising number of deaths due to viral hepatitis, last year, the Union government had launched the National Viral Hepatitis Control Programme.
Hepatitis B and C (both liver infections) are transmitted through activities that involve contact with HBV infected blood or body fluids, including injection of a drug that involves sharing needles and syringes, or drug preparation equipment of infected persons, sexual contact and sharing razors and toothbrushes (infrequent modes of transmission in the case of Hepatitis C), among other routes.
Hepatitis B can also be transmitted from the infected mother to the child at the time of delivery, or contact with blood or open sores, wounds and ulcers of infected persons. Hepatitis C can be transmitted through transfusion of unscreened blood and blood products, and needle stick injuries.
Amid the COVID-19 pandemic, viral hepatitis continues to claim thousands of lives every day, the WHO said on Monday.
Meanwhile, the central government reiterated its goals of eliminating and reducing the burden of viral hepatitis. “We are committed to the WHO goals of elimination of Hepatitis C and of reducing the burden of Hepatitis B by 2030,” Om Birla, speaker, Lok Sabha, said at the empathy e-conclave organised for parliamentarians by the Institute of Liver and Biliary Sciences and Airports Authority of India.
Union Health Minister Dr Harsh Vardhan said hepatitis is now a global health problem. “Viral hepatitis is a very common and serious disease in India, but is virtually unknown to health care providers and the general public. Individuals with viral B and C hepatitis are at increased risk for liver cancer and chronic liver disease. Yet an estimated 80 per cent of persons with chronic viral hepatitis do not know that they are infected,” he said at the event. Vardhan said the approach had to be “talk, test and treat” and appealed for supporting the ILBS in the viral hepatitis campaign.
Ghildiyal pointed out that the delay in conducting baseline tests would leave the high-risk populations such as people living with HIV, those who inject drugs, those among the LGBT community, at high risk of liver complications. “Like any other responsible citizen of India, we are also concerned about the COVID-19 pandemic. We are not suggesting that COVID-19 be ignored, but demanding that we be treated, too.”
