Expensive to Treat, Will Hepatitis Soon Be the Next Big Killer?

#WorldHepatitisDay - 4 to 6 crore Indians are infected with Hepatitis, is India equipped to handle the epidemic?

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Health News
4 min read
One in three persons affected with blood-borne viral hepatitis-B and C in India at a risk of developing liver cancer, yet most of them are not aware of their infection.
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(July 28th is observed as the World Hepatitis Day. Globally 1.4 million people die each year from hepatitis and this day serves as a reminder to governments and policy makers to know the disease and take action)

“Infected”, “virus”, “disease” and “chronic” are not words you want to hear from your doctor, not at any time, especially not in your early twenties.

37-year-old Mumbaikar, Shekhar heard the exact words 15 years back at the age of 22.

I had no symptoms and could never imagine living with a chronic blood disease like Hepatitis C. There was hardly any awareness at that time. I was crying because I had something inside me, wondering how early will I die.
– Shekhar *, Hepatitis Patient

According to the World Health Organisation, around one lakh Indians die of hepatitis every year. 4-6 crore people in the country are carriers of this viral disease, and most of them are unaware of their infection, putting them at a serious risk of developing liver cirrhosis or liver cancer.

Yet the government doesn’t even have a hepatitis policy or an eradication goal.

Snapshot
  • WHO: Hepatitis is 3 times more infectious than HIV.
  • WHO: 4-6 crore Indians get infected from Hepatitis; a lakh succumb to the disease every year.
  • India did not have facilities to screen blood for Hepatitis till 1996. Many people unknowingly got infected before that.
  • Health Ministry: 40% infants are still not vaccinated against Hepatitis B & C.
Expensive to Treat, Will Hepatitis Soon Be the Next Big Killer?
(Photo: FIT)
Expensive to Treat, Will Hepatitis Soon Be the Next Big Killer?
(Photo: FIT)

Government Woefully Under Equipped to Handle the Spread

Hepatitis B is the most severe type of hepatitis; 4 out of 5 times if left untreated, chronic hepatitis B causes liver cancer or cirrhosis (Photo: iStock)
Hepatitis B is the most severe type of hepatitis; 4 out of 5 times if left untreated, chronic hepatitis B causes liver cancer or cirrhosis (Photo: iStock)

India did not have proper facilities to screen blood for hepatitis virus till 1996. A vast majority of those infected with hepatitis C are baby boomers, according to the WHO. Most were infected decades ago, and many got it from blood transfusions that they received before 1996 when donated blood was not screened for the virus.

The problem is that it takes around two months after the blood test and the manifestation of the virus. Some hospitals do not wait for that long and transfuse the blood before that period. 
Vinay Shetty, Vice President, Think Foundation
Viral hepatitis is three times more infectious than HIV and has surpassed HIV, malaria and tuberculosis as a leading cause of death from an infectious disease. And yet, the government does not have a national policy on hepatitis or a goal to eradicate it.

37-year-old Shekhar, is currently hospitalised, waiting for a matching organ for a transplant. Alcohol coupled with hepatitis diagnosis scarred his liver permanently.

Health workers receive skills and expertise needed for  taking care of viral Hepatitis patients  on-the-job (Photo: iStock)
Health workers receive skills and expertise needed for taking care of viral Hepatitis patients on-the-job (Photo: iStock)

40% infants not vaccinated against hepatitis A and B: Both these strains have a preventive vaccine under the government’s immunisation programme; yet according to the health ministry’s own records, only 60% newborns were vaccinated against hepatitis B in 2014. With no national policy for screening, zero awareness for recognising symptoms and early diagnosis, this is a ticking time bomb.

Hepatitis deaths are not reported to a central agency: No government agency maintains the record of hepatitis deaths. The figures which are available are estimates by the WHO based on the data reported at the regional/ district level. The actual number of hepatitis cases might be much higher.

International funding for hepatitis is minuscule. Life-saving drugs are so expensive and inaccessible that not being HIV positive has become a cruel public health irony.

Lack of testing facilities: The WHO says there are few labs to test the virus in India and the available test is only 80% precise.

Related Read: I’m Alive Only On 25% Of My Liver: Amitabh Bachchan

The Haves & Have Nots

Hepatitis A, B & C are caused by three different viruses. Each has similar symptoms but attacks the liver differently (Photo: iStock)
Hepatitis A, B & C are caused by three different viruses. Each has similar symptoms but attacks the liver differently (Photo: iStock)

For a majority of Indians suffering from hepatitis B and C, there is a “vial” of hope. A six month course of the only medication available was priced at a whopping 1.8 crores!

No insurance covers the medicine cost, even the government has not included it in the “essential medicine list”, because treating only a fraction of the infected population will topple the health budget.

But now, with Indian companies making a generic version of the hepatitis drug, the treatment is available at less than Rs 2 lakhs. It is still out of reach of a majority of Indians, immediate government intervention is needed to arrest the spread before it becomes an epidemic.

*Name changed to protect privacy.

Related Read: Liver Disease - Yet Another Reason to Get Off Your Butt

(For more stories on hepatitis, follow FIT)

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