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Introduction

Observed every year on 28 July, World Hepatitis Day provides an opportunity to raise awareness, enhance understanding, and promote action to prevent, diagnose and treat hepatitis. This year’s theme for World Hepatitis Day is ‘It’s time for action’, which underscores the urgency of addressing this critical health issue.

Indian Scenario

As per 2023 HIV Sentinel Surveillance plus report², the national seroprevalence for hepatitis B and hepatitis C was found to be 0.85% (95% CI 0.85-0.86) and 0.29% (95% CI 0.29-0.30) respectively. According to the epidemiological classification accepted internationally by World Health Organization for hepatitis B, India therefore falls under the ‘Low prevalence’ category (i.e. <2%). There is no such internationally accepted epidemiological categorization in context to seroprevalence of hepatitis C.

Government of India’s initiative: National Viral Hepatitis Control Program (NVHCP)

National Viral Hepatitis Control Program was launched in 2018 under National Health Mission with the aim to combat hepatitis and eliminate hepatitis C by 2030 and reduce morbidity and mortality due to other types of viral hepatitis in line with the target 3.3 of Sustainable Development Goal (SDG). Under the program, free diagnostics and drugs are being made available to all eligible, not only for treatment of hepatitis C but also management of hepatitis B. The key strategies adopted under the program include preventive, promotive and curative interventions with the focus on awareness generation, increasing access, capacity building of all concerned stakeholders, promoting diagnosis and providing treatment for viral hepatitis across the country in sync with the universal health coverage.

The program through the National Health Mission has formulated strategies utilizing the existing resources in health systems including infrastructure, manpower and established mechanisms of diagnostics and treatment services optimizing equitable access to services with financial efficiencies. The treatment services are delivered through designated treatment sites located within existing health facilities such as district hospitals and medical colleges/institutions. Referral centres named as Model treatment centres (MTC) located in tertiary level healthcare facilities have also been strengthened in all states/UTs to act as referral units for management of complicated cases.

 National guidelines for diagnosis and management of viral hepatitis have been developed by experts from across the country so as to ensure standardization of the laboratory and treatment protocols and are available on the NVHCP website i.e. www. nvhcp.mohfw.gov.in.

For efficient monitoring and evaluation, the program is moving towards a paperless data recording and reporting system through the NVHCP Management Information System (NVHCP-MIS) portal. A helpline has also been established for generating awareness about viral hepatitis and informing about the services being provided under the program.

The Program has strengthened 978 treatment sites in 711 districts across the country. It has screened 10.34 crore individuals for hepatitis B & C and provided treatment access to 3.3 lakh patients till March 2024 since its inception. 

Additionally, the program has integrated with existing national programs/schemes, including the National Program for Surveillance of Viral Hepatitis (NPSVH), Maternal health and Universal Immunization Program component of RMNCAH+N, National AIDS Control Program and National TB Elimination Program amongst other to ensure effective implementation and financial efficiencies.

As a step towards achieving the target 3.3 of SDG, National Viral Hepatitis Control Program, is also now focusing on surveillance and monitoring systems to accurately analyse and track viral hepatitis trends. Further, the program is currently in the phase of expansion so that services get provisioned till the last tier of healthcare facility.

References:

[1] Global hepatitis report 2024: action for access in low- and middle-income countries. Geneva: World Health Organization; 2024.

² Seroprevalence of Hepatitis B and hepatitis C (HIV Sentinel Surveillance plus 2021, round 17) report, 2023.

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Santosh Kumar/ Sarla Meena/ Sheetal Angral/Ritu Kataria/Abhinandan Sharma

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