Hepatitis C virus on alarming rise in Nagaland

KOHIMA, JULY 27: ‘Viral Time Bomb’ is a term coined by WHO for viral hepatitis, which not only affects the Injecting Drug Users (IDUs) as people commonly believe, but the virus showed its presence among the general populace too in the recent years.
As per the 7 years report of Naga Hospital Authority of Kohima (NHAK) made available to Eastern Mirror, it showed the presence of the virus among the general population at 1.8 %, signifying it as a public health concern and not just that of Injecting Drug Users (IDUs).
As the state gets ready to observe the World Hepatitis Day week on July 28, it is learned that Hepatitis C has always been an area of concern for the people of Nagaland but in absence of any documentation or research data, not much could be done by the State government, NGOs and agencies working in the health sector. Though Hepatitis C is curable with treatment lasting from 6 months to 1 year, cases of HCV related deaths have been reported, and that people continue to die of a preventable and curable disease because of ‘lack of awareness and high treatment cost’.
The cost of the treatment is also reportedly very expensive, thereby making it impossible for the weaker section of the community to avail the treatment.
Talking to Eastern Mirror, Ketho Angami, Secretary of Hepatitis Coalition of Nagaland (HepCoN) said it was only in 2005 ICMR did a small scale study on the disease burden among the Injecting Drugs Users (IDUs) in Kohima and as per the data, 30 IDUs have been tested reactive for HCV out of a total sample size of 98 IDUs.
He said, the HBV and HIV among these respondents’ remains to be comparatively low with only 3 HIV positive and 1 HBV positive as prevalence rates.
Ketho said that the burden of HCV in Nagaland came to the limelight with the research data of Phek and Wokha being documented by the Indian Council of Medical Research (ICMR/RMRC), through the Integrated Bio-Behavioral Assessment (IBBA) study among IDUs in 2006 and 2009. According to the Data, the prevalence rate in Phek stood at 5.4% (2006) to 8.7% (2009) and 16.7% (2006) to 20.8% (2006) in Wokha, signifying not only an alarming rate of HCV infection among this community but also an ever increasing trend.
While stating that Hepatitis C issue in Nagaland has emerged to be of urgent concern, he lamented that not much has been done by the state government, civil organizations nor the NGOs working in the field of HIV/AIDS and other health sectors, whereas the epidemic continues to spread rapidly and at an alarmingly rate.
He asserted that the emerging threat has to be addressed now, ‘if not people of Nagaland in general and particularly the IDUs will face a huge HCV disease burden thus challenging the very State health programs, in the coming years’.
Without any proper programs on HCV in Nagaland, Ketho lamented that even the NACO programs which work with the IDUs have focused only on HIV prevention, thus overlooking the seriousness of the HCV prevalent in the state, which always remain neglected.
Therefore, with nothing happening with the silence of the government and the health department playing the ‘pull and push’ game on this issue, inspite of its repeated reminders and talks, Ketho said with an aim to addressing the issue and taking the agenda forward, the Nagaland Users Network (NUN) started initiating small projects on raising awareness about the epidemic among their peers i.e. people who use drugs (PUDs) and have also initiated a 60-day signature campaign with the support of Kohima Users Network (KUN). The campaign was conducted targeting the IDUs and their service providers, to provide them information on how HCV is transmitted, preventions and treatments.
Though MSD pharma also started partnering with NHAK and established a liver clinic whereby free diagnostics (Antibody RNA, genotyping) were provided, and treatment medicine with Pegylated Interferon (Veraferon-Alfa 2B) and Ribavirin were also made available, Ketho said it comes at a very exorbitant price with a single vial priced at almost 18000/- INR. Hence, he said the marginalized community like PLHAs and PUDs continue to die because of financial constraints.
It is informed that MSD company has reduced their price to 9000 INR per vial irrespective of the MCG whereas the combination treatment of Ribavirin is given free of cost.
To respond and address the Viral Hepatitis particularly HCV in Nagaland, Ketho said Hepatitis Coalition of Nagaland (HepCoN) was formed on August 9, 2013 at Kohima. So far, he said, HepCoN has reached out to 6 districts in Nagaland with HCV awareness program, while the remaining 5 districts are expected to be covered within this year.
He also informed that to upscale HCV services, HepCoN has also invited Zydus Heptiza to Nagaland and has facilitated in establishing Similar Liver Clinic as that of MSD in Kohima at Family Planning Association of India (FPAI) and Dimapur Civil Hospital, where treatment product (Pegihep) also was made available in both the two districts priced at 5250/-INR.
Sensing the urgent need to address this growing issue, Ketho has pressed on the need to create preventive awareness among the general mass, whereby he also asserted that testing facilities should be provided with wider coverage, and made available in the other districts too.
Also citing the expensive treatment cost, he said the decline in the price will enable more people to avail testing and treatments. He also said that there is a need of a state level data which has to be generated through some research studies by recognized Research body in collaboration with the state government, as a further reference for further advocacy.
Most importantly, Ketho maintained that the state government has to take ownership (political will) of the problem and address the health needs of its citizens.