There is an estimated 40 million people infected with the Hepatitis B virus in India
World hepatitis day- the real ‘missing millions’ are those who perish because of unaffordable liver care
Mr Ray of Santa Cruz Bombay was left aghast when he found out that his nephew perished from cirrhosis ( permanent liver damage) of liver. The young man (49yrs) had been advised a liver transplant because his liver was damaged from long standing diabetes, however a transplant was not an affordable option for him.
And that is the case with millions of Indians who suffer from liver disease. Hepatitis B and C virus induced liver damage remains rampant in India, and there is an estimated 40 million people infected with Hepatitis B virus in India.
Hepatitis B mainly spreads through unsafe sex, contaminated blood transfusion, pregnant mothers to their children. Hepatitis C affects an estimated 18 million people, and is transmitted though contaminated blood transfusion, contaminated needles and injections.
The real danger is NAFLD (non alcoholic fatty liver disease) or fatty liver. With the epidemic of obesity currently spreading across India and India being the diabetes capital of the world, fatty liver disease affects a huge population of Indians. In majority of cases the liver damage remains subtle and progresses undetected till significant destruction has been done.
At that point the person will have water in his tummy, yellow eyes( jaundice), or confusion and the only viable treatment option at this stage remains a liver transplant. A conservative estimate of cost analysis of a person with liver damage proceeding to transplant and follow up care runs into a comfortable Rs 50-60 lakh over 5 to 7 years, provided that he doesn’t run into any added complications.
Out of every 100 patients needing a liver transplant in India, for 30 it is unaffordable, for 50 patients there is also no willing donor
This group of people constitute the real ‘missing millions’ in India. A brief survey carried out in a liver center in South India shows that out of every 100 patients needing a liver transplant in India, for 30 it is unaffordable, for 50 patients it’s unaffordable plus there is
no one to donate a part of liver to the patient.
India has emerged as a global leader in living donor liver transplantation, with around 2000 liver transplants being performed annually, it still this falls short of the 25000 transplants that are estimated to be required in the country. Transplant centers in India
serve a huge number of International patients as well making liver transplantation a truly ‘make in India’ story.
Sadly, many Indian patients have to make significant out of pocket investments for affording quality liver care, pushing their families towards the poverty line. Medical insurance is negligible and does not cover full expenses of a liver transplant and if there is any indication of the word ‘alcohol’ anywhere, insurance companies are prompt in refusing such claims.
The need of the hour is a comprehensive liver care package with combined efforts of the government, medical insurance and health care officials so that none with liver disease is denied treatment for want of funds.
