Viral hepatitis- A challenge to India’s public health

Source-This post on Viral hepatitis- A challenge to India’s public health has been created based on the article “How viral hepatitis poses a challenge to India’s public health, with second highest prevalence globally” published in “The Indian Express” on 15 April 2024.

UPSC Syllabus-GS Paper-2– Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.

Context– India has one of the highest burdens of viral hepatitis in the world, according to the World Health Organization’s Global Hepatitis Report 2024. It’s tied with tuberculosis (TB) as the second-largest infectious killer globally. Viral hepatitis

What is viral hepatitis?

Description-Hepatitis means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood, and fights infections. When the liver is inflamed or damaged, its function can be affected. It is often caused by a virus.

Types-There are five hepatitis viruses that cause liver disease in humans.They are Hepatitis A, B,C,D and E.

Transmission– Hepatitis A and E are transmitted through contaminated food and water, and result in week-long symptoms such as fever, abdominal pain, jaundice (yellowing of skin), dark urine, and pale stools.

WHO report-The recent WHO report pertains to the blood-borne hepatitis B (hep B) and hepatitis C (hep C) viruses. The report does not consider hepatitis D because it only infects people who are already infected with hepatitis B.

 Prevention-Hep B can be prevented by vaccination, while hep C can be cured with medication. Hepatitis D can be prevented by vaccinating against hep B.

What are the reports finding about India?

Disease burden-According to the report, India ranks second globally in terms of viral hepatitis cases, representing over 11% of the total burden worldwide.

Diagnosis– The diagnosis of viral hepatitis was extremely low. The report shows that only 2.4% of hepatitis B cases and around 28% of hepatitis C cases were diagnosed.

Read more- Havisure: India’s first indigenously developed Hepatitis A vaccine

What’s causing the increase in viral hepatitis cases in India?

Viral hepatitis can be transmitted through contaminated blood transfusions, or through contaminated needles.

1) Hep B-India’s hep B cases are driven up by mother-to-child transmission. This is because most blood banks offer safe blood, and the risk of needle-stick transmission among healthcare workers is low because almost everyone is vaccinated.

2) Hep C– According to the WHO report, India is among the ten countries where 80% of infections occur among injection drug users.

3) Underutilization of existing facilities– People aren’t taking advantage of the free diagnostics and treatment available to them.

4) Disparity in treatment– While viral hepatitis causes almost as many deaths as tuberculosis, it doesn’t receive as much attention in India. As per the report, none of the diagnosed patients received treatment for hepatitis B, and only 21% received treatment for hepatitis C. In contrast, 95% of diagnosed TB patients in India were given therapy.

What challenges do India face in handling viral hepatitis?

Hep B-There are 3 things that are required to be controlled such as-

A) All newborns need to be fully vaccinated against hepatitis B.
B) Adults who haven’t been immunized should also get the shot.
C) Additionally, everyone diagnosed with the infection should receive treatment.

Low coverage- The hepatitis B vaccine was introduced for children in 2007-08 as part of the government’s universal immunization program. However, a 2019 study revealed that its coverage ranged from 41% to 62%.

Lack of universal care-The parameters mentioned in the international guideline for initiating treatment exclude 7 to 8 of the 10 people who are diagnosed with the infection. Thus, there is a need to adopt a ‘treat all’ or universal approach like HIV.

Question for practice

What’s causing the increase in viral hepatitis cases in India? Highlight the challenges that India faces in handling viral hepatitis?