In India, more people are estimated to be carrying the Hepatitis C virus than suffering from HIV Aids or cancer. But most don’t even know that they’re sick
A medical emergency can erupt in any form or intensity. While there are some that pose an immediate threat to life, such as outbreaks of diseases like cholera, ebola, and malaria, other emergenies, like cardiovascular ailments, cancers and chronic respiratory diseases are not immediately life-threatening, but can still have serious implications on the health and well-being of the people.
Two approaches have to be used to battle two types of ailments. But what if a rogue bug crosses the line and attempts to destroy the system from within the human bodyIJ What if it enters masquerading as a relatively harmless malady and then slowly transforms itself into something that’s beyond our controlIJ Such is the case with the Hepatitis C virus. A drastic change in strategy is needed to battle this disease, including immediate preventive action.
The Government has to tackle this deadly crisis-in-waiting. It must declare the eradication of Hepatitis C to be a national health priority, and drive the campaign full throttle. Nearly 96,000 people die annually due to Hepatitis C in India — a hidden epidemic, according to the World Health Organisation. The estimated prevalence of Hepatitis C Virus in India is between 0.5 percent to 1.5 per cent. This means that of the 1.25 billion Indian people, more than 12.5 million population is infected by HCV.
The number of victims that this deadly virus has in its grips surpasses that of HIV or cancer. Once it gets into the blood stream, it refuses to be cleansed out. Constant vigil is required to prevent it from entering the body. It is a difficult task because this mortal malady is invisible. It enters silently, launches a vicious attack on the liver, damaging it beyond repair. All this while the victim remains unaware because there are no symptoms. It can take anywhere from six weeks to 25 years or more before the victim becomes aware of the symptoms.
Hepatitis viruses pose a serious ‘silent epidemic’ challenge in India because infected persons are unaware of their chronic carrier status, and continue to infect others for decades. This inevitably leads to the loss of productive workforce, while exerting backbreaking pressure on the country's health care system.
Making people aware of the high risk environments and practices; informing them of how to steer clear of the virus is vital. For instance, HCV infections are commonly caused by exposure to infected blood during transfusions, transplantation or dialysis. Epidemics triggered by contaminated equipment, transmission through unsafe sexual intercourse, and from mothers to infants are also well-established.
Is India building up a formidable defence lineIJ India has a national strategy that focuses exclusively on prevention and control of viral hepatitis but there is no routine surveillance of the disease. The Government does not publish hepatitis reports. Also, there is inadequate laboratory capacity nationally to support investigations of outbreaks and other surveillance activities.
HCV is a ticking bomb. An astounding 25 and 40 million Indians are living with Hepatitis B and C. Only a handful of them can afford treatment. Prevention must be the key theme of the Government’s anti-HVC strategy. Programmes to improve awareness need to be scaled up. Effective treatment options need to be implemented.
Also, there is now a new line of medicine that can revolutionise treatment. Sofosbuvir, a new ‘magic’ drug for treating HCV infection, which was till now considered incurable, has been launched in India. It can be introduced at any stage and has tested to be almost 90 per cent effective. It is much cheaper than the existing treatment process. The new once-a-day, pop-up pill treatment replaces the exceptionally cumbersome traditional injection therapy, which was expensive, lengthy and had side effects.
(The writer is Chairman, Institute of liver Gastroenterology and PancreaticoBiliary Sciences, Sir Ganga Ram Hospital, New Delhi)