According to the World Hepatitis Alliance, viral hepatitis is the seventh leading cause of death globally, accounting for 1.4 million deaths per year, more than HIV and AIDS, TB, or malaria.
In May 2016, during the 69th World Health Assembly, 194 member states of the World Health Organization made a historic commitment to eliminate viral hepatitis by 2030, with governments unanimously voting to adopt the first ever Global Viral Hepatitis Strategy, signalling the greatest global commitment in viral hepatitis to date. The strategy addresses all five hepatitis viruses (hepatitis A, B, C, D and E), with a particular focus on hepatitis B and C, owing to the relative public health burden they represent.
In Nagaland, hepatitis, particularly hepatitis C or the HCV, has long been considered an orphaned disease. Health activists are of the view that while other diseases have the health department to take care of them, yet many agencies, including the central and the state governments have so far ignored the hepatitis C issue. It is also unsettling that many people in Nagaland are still said to be ignorant of the virus.
The negligence has apparently led a few likeminded people from organizations which work to reform drug users and PLHIVs, who are also vulnerable groups, to take the challenge upon themselves to propagate awareness about HCV under the aegis of Hepatitis Coalition of Nagaland (HepCoN) since 2013. The organizations include Nagaland Users’ Network, Nagaland Network of People living with HIV and AIDS, and N-Naga DAO.
According to the coalition, the health priority is not HIV any longer, it is HCV all out now. After the WHO made World Hepatitis Day, July 28, one of only four official disease-specific world health days in 2010, the occasion became a significant platform for raising awareness about hepatitis and influence real change in prevention, testing and treatment of the infection. Millions of people across the world take part in World Hepatitis Day, to raise awareness about viral hepatitis, and to call for access to treatment, better prevention programs and government action.
In solidarity with the global movement, World Hepatitis Day programs are organized in the state by NGOs like HepCoN, seeking to bring people together under one platform to speak out, be engaged and seek the government’s intervention and action to ensure the elimination of viral hepatitis amongst the state’s general population.
In just two months of screening conducted between May and June this year, it was reported that the prevalence of HCV in the state stood at 2.43% comprising 3.90% among the male population and 0.52% among the female population.
Despite high rates of HCV prevalence being reported in the state, it was highlighted during the observation of World Hepatitis Day in Kohima that the state is yet to even set up a testing and diagnosis facility, leave alone access to affordable treatment drugs, while the neighbouring Manipur, Tripura and Mizoram are said to be providing free diagnosis and medicines to the people.
In the words of a Kohima-based health activist, “People (in Nagaland) continue to die of a preventable and curable disease because of the lack of information and because of high treatment costs.”
HepCoN has this year forwarded a number of recommendations to the government of Nagaland to address the
burden of Hepatitis C in the state: initiating a state surveillance system through the Health departments or the IDSP while another recommendation sought the government to ensure availability of hepatitis diagnostic facilities besides treatment drugs in all public health facilities. The government was also requested to take the lead role in organizing World Hepatitis Day events and to introduce government health schemes for the treatment of HCV.
It is high time that the state government and its health department take hepatitis C as a pandemic and a major health issue.
