Shri Manish Sisodia Ji, Delhi; Shri Naresh Kumar, Chief Secretary, Delhi; Secretary Health, Amit Singla; Dr S.K Sarin, Director, ILBS; experts, faculty and students,
Good afternoon, it is a pleasure to meet on this auspicious Makar Sankranti Day, and to wish you all a Happy New Year.
My sincere gratitude to Dr S.K Sarin and the Institute of Liver and Biliary Sciences (ILBS) for inviting me to address you on the 13th Foundation Day of this august, world-leading institution.
My heartfelt thanks for the Institute’s valuable support as a WHO Collaborating Centre;
For its active contributions throughout the COVID-19 response;
And for its steadfast efforts to strengthen access to quality, affordable care for viral hepatitis and other liver diseases in India and across the South-East Asia Region.
From Project Prakash to Project Empathy, and on to the Institute’s high-level advocacy on the avoidable impact of non-alcoholic fatty liver disease, the ILBS continues to be a beacon of the best science for better clinical and public health outcomes.
My congratulations on the Institute’s 13th Foundation Day, and my sincere hope for many more years of successful, high-impact collaboration, not just sustaining but accelerating momentum to enhance liver health and eliminate hepatitis as a public health threat by 2030.
For that, you are aware: Last year was particularly significant.
First, on World Hepatitis Day, WHO launched a new global advocacy campaign that focuses on integrating quality, accessible and affordable hepatitis care into primary health care services.
The campaign is aligned with the Region’s Strategy for Primary Health Care, launched in December 2021, as well as new WHO Global Health Sector Strategies on HIV, viral hepatitis and sexually transmitted infections (STI) 2022–2030.
Second, in September, at the Seventy-fifth Session of the Regional Committee, Member States unanimously endorsed the Region’s new Integrated Action Plan on Viral Hepatitis, HIV and STI (I-RAP).
For the first time, the I-RAP covers all three diseases in one plan, recognizing their common determinants and modes of transmission, prioritizing equity and innovation, and advancing people-centred and community-driven approaches.
And third, in October, we held the first meeting of our new regional Strategic and Technical Advisory Group on Viral Hepatitis, HIV and STI, as well as a meeting of national programme managers from across the Region.
I am pleased to report that both events were a great success and will accelerate action towards our targets and goals:
Namely, by 2025, to reduce new infections of hepatitis B and C by 50%; to reduce deaths from liver cancer by 40%; to ensure that 60% of people living with hepatitis B and C are diagnosed; and to ensure that 50% of those eligible receive treatment.
And of course, by 2030, to eliminate hepatitis as a public health threat.
In the months and years ahead, accelerating progress in India, the South-East Asia Region and world could not be more urgent.
Globally, nearly 354 million people are estimated to be living with chronic hepatitis B and C, of which at least 20% are from our Region.
Every year, around 3 million people newly acquire hepatitis B and C infection globally, of which close to half a million are from our Region.
The South-East Asia Region accounts for nearly 220 000 of the 1.1 million lives lost to hepatitis B and C globally each year.
Across the Region, just 10.5% of people who are eligible for anti-viral treatment know their status, and of them, only 4.5% are on treatment.
Of the estimated 10.5 million people with hepatitis C, just 6.9% know their status, of which around 1 in 5 are on treatment.
You will agree: These numbers are as vast as they are unacceptable.
However, they contain within them an important truth.
And that truth is that with the right policies, implemented in an appropriate manner – with the requisite courage, fortitude and resolve – together we can not just improve but transform the health and well-being, lives and livelihoods of people, communities and countries across our Region.
For that, WHO is highlighting four priorities:
First, in all countries, the need to strengthen political commitment to eliminate hepatitis, which must be translated into increased investments in high-quality, people-centred hepatitis care.
Second, ensuring access for all to safe and effective vaccines and drugs, and point-of-care diagnostics, the cost of which should be integrated into national health and domestic financing. On this, the Chief Secretary has just suggested that WHO collaborate to develop a vaccine for liver cancer.
Third, strengthening communication and community engagement strategies to reduce stigma, and to increase awareness and testing, especially among populations at higher risk.
And fourth, designing and implementing services that are close to where people live and work, and which are aligned with people’s needs, preferences and health-seeking behaviours.
I am pleased to note that India has made significant progress on priorities one and two in particular.
Since 2018, under the National Viral Hepatitis Programme, people in all states and union territories have had free access to diagnostics and drugs for hepatitis B and C, which has so far benefitted more than 4.44 crore individuals and treated more than 1.74 lakh patients.
For this, the ILBS has played a critical role, especially in raising high-level awareness and action, including among parliamentarians – a best practice that can be replicated in other countries and contexts.
But today, as India continues to accelerate action on priorities three and four, the message I want to focus on is the need to actively seek out and nurture strong, effective and durable partnerships, especially at the community level.
We know that to increase awareness and uptake of hepatitis prevention, testing and treatment, communities must be communicated with, engaged and empowered on their own terms.
This approach has proven especially successful for HIV, where the paradigm shifted from ‘for’ the community, to ‘with’ the community, and finally to ‘by’ the community.
I urge all policy makers and programme managers to increasingly reach out to, consult with, engage and empower community-based organizations and other key actors – such as media – with a focus on reducing hepatitis-related stigma, and accelerating demand for testing and treatment, especially among key populations.
Similarly, we see that community-based partnerships can help create, support and nurture hepatitis services that are aligned with and reflect people’s needs, behaviours and concerns.
On this, the ILBS’ own work with Mohalla clinics in Delhi is instructive, at once increasing access to testing, while at the same time saving patients time, travel and expense – outcomes that are by no means incidental.
The findings of the HEAD start project are clear: testing and treatment strategies that are decentralized and community-focused can yield outcomes comparable to those from tertiary level facilities, while at the same time reaching many more people, thus maximising public benefit.
I put it to you: The future of hepatitis care in India, the South-East Asia Region and world must be community-focused, based and led, matching the highest level of political commitment with the strongest foundation of grassroots knowledge, power and action.
I thank and commend the ILBS for its tremendous leadership in this regard and reiterate WHO’s ongoing and unmitigated support.
I once again wish this august, world-leading leading institution a happy 13th Foundation Day and look forward to our onward journey together, to continue to apply the best science for better clinical and public health outcomes.
Thank you.