PIL wants treatment for Hepatitis C to be free of cost in public hospitals

Demanding that treatment for Hepatitis C virus be provided free of cost in Delhi, activists have filed a public interest litigation in Delhi High Court. Currently costs of treatment including drugs and diagnostics can run into over Rs 50,000 for a patient and often is impossible for poor patients to afford.

The PIL demands that the entire treatment be made available free of cost in Delhi's public hospitals and the High Court has instructed the Delhi government to file a status report regarding this.

Activists have been pushing for free treatment of Hepatitis C in major hospitals like GB Pant, All India Institute of Medical Sciences and Ram Manohar Lohia Hospital. Even after a year of promises and bringing drugs like Sofosbuvir and Daclatasvir under the National List of Essential Medicines (NLEM), which means that they are supposed to be available for free at all government hospitals, the drugs are unavailable.

Patients have to buy Daclatasvir from private chemists, and a pack size of 28 tablets costs Rs 6,000. Up to 150 patients throng the Out Patient Department corridors of GB Pant Hospital every day. They come from all across India, mostly the northern parts, to seek treatment. And when they are asked to procure medicines from private chemists, which they obviously cannot afford, they drop out of treatment.

These people are at risk of a slow progression to severe liver disease and death, unless they receive timely testing and treatment.

"We have been running pillar to post meeting health officials in the Delhi government who keep assuring us that they will address the issue of Viral Hepatitis but we see poor and marginalised patients from Delhi - who urgently need essential diagnostics and medicines goes without the lifesaving treatment.This is not acceptable to us and therefore we have gone to the High Court of Delhi to enforce the right to health of people with chronic HCV living in Delhi," said Paul Lungdhim from Delhi Network of Positive People (DNP+).

Loon Gangte from International Treatment Preparedness Coalition (ITPC) pointed out that free testing and treatment for Hep C was not available in Mohalla clinics at the moment.

In the petition, DNP+ has highlighted that neighbouring states like Punjab and Haryana, in line with the above WHO guidelines, have publicly funded HCV testing and treatment programmes, which is a model that Delhi ought to pay heed to, if not emulate it.

HEPATITIS C

What does it cost a patient?

While drugs cost Rs 30,000, there an entire battery of diagnostic tests – Hep C RNA tests to be done thrice over the course of treatment –a total of Rs 6500, a genotype test costing another Rs 3000, a haemogram or a complete blood count, a liver function test and a liver fibroscan all of which approximately add another Rs 5000 to the out-of –pocket expenditure for the patient.

What is the burden of Hep C in India?

In India, it is estimated that between 60 lakhs to 1.1 crore persons are infected with Hep C annually. In 2015, an estimated 59,000 patients died. A faulty blood transfusion during an emergency surgery up to two decades ago, or a dental cleansing procedure using non-sterile equipment or an act of tattooing or indulging in unsafe sex can lead to infection. Yet, Central Bureau of Health Intelligence has recorded not more than 1, 42,148 cases of viral hepatitis (which includes both B and C types) and only 446 deaths during 2016.

Costly affair

In India, it is estimated that between 60 lakh to 1.1 crore persons are infected with Hepatitis C annually.
While drugs cost Rs 30,000, there is an entire battery of diagnostic tests that cost about Rs 14,500, and if done only once.