Naimpal Bhatti, 43, found out he had hepatitis C but could not avail treatment because it was too expensive. “I didn’t know how dangerous hepatitis C is. But now that I know, I take all measures to make sure that no one else gets infected” he said. In 2017 he received treatment at the hepatitis C clinic in Meerut’s P L Sharma district hospital and was declared cured in November of the same year. Since January 2017, MSF in partnership with the National Health Mission – Uttar Pradesh and P L Sharma hospital initiated a pilot project in Meerut to treat complicated cases of hepatitis C. Last month, MSF transferred all activities to the National Health Mission since the launch of the National Viral Hepatitis Control Program (NVHCP) by the Ministry of Health. The clinic was the first such public facility to provide free, simplified and decentralized care to patients in the State.
Currently, the National Health Mission- Uttar Pradesh is in the process of rolling out the ‘State Viral Hepatitis Programme’ at ten district-level treatment sites, which will be supported by four ‘model treatment centres’ at Meerut, Lucknow, Varanasi and Allahabad. The Hepatitis C clinic in P L Sharma hospital in Meerut has been recognized as one such treatment centre. Between January 2017 and November 2019, MSF treated a total of 3314 patients among which 3164 were declared cured.
“The model of care developed by Médecins Sans Frontières in P L Sharma hospital was very innovative as it offered free testing and treatment at the district hospital level, which ensured simplified access to care for the patients. Counselling and health promotion were also key components of the services provided to the patients” said Dr Hemant Sharma, Project Medical Referent with MSF during the closure ceremony.
The state hepatitis programme is vital to ensure a large cohort of people are treated. It is currently estimated that 6-12 million people are affected with hepatitis C with western Uttar Pradesh considered as a high burden area. Hepatitis C is transmitted most commonly through injectable drug use, unsafe injection practices including the transfusion of unscreened blood or blood products. The good news is, with a new generation of drugs (called Direct Acting Antivirals) arriving in 2016, treatment has become shorter and more affordable.
Manipur project podcast:
Last year, we had freelance journalist Menaka Rao visit our Manipur project where we provide specialised care for TB, HIV and Hepatitis C. As the only medical humanitarian NGO in the state, the focus has been to develop a patient-focused model of care to improve treatment outcomes and minimise the spread of the diseases. In her podcast for Suno India, Menaka attempts to understand the risks of TB infection among the drug user community by talking to patients treated by MSF and staff working at the project. She also explains how the use of opioids itself makes a person more vulnerable to TB. MSF provides screening, diagnosis and treatment for HIV, TB, Hepatitis C and co-infections at three clinics in Chakpikarong, Churachandpur and Moreh respectively. In Churanchandpur, MSF also runs an opioid substitution therapy (OST) centre to reduce the risk of further infection through the sharing of needles.
2019 also marked 20 years since MSF was awarded the Nobel Peace Prize and the 20th anniversary of the founding of Access Campaign, which has been working to secure access to affordable medicines, diagnostics and vaccines for people in MSF’s care and beyond. Each year, Access Campaign comes up with a wish list, with the same objective: Medicines shouldn’t be a luxury. In 2020, we continue to wish for a world where medicines are not commodities or luxuries but where everyone has fair access to treatment to stay alive and healthy.
Fighting for affordable medicines is a continuous process. While drugs for diseases like Tuberculosis and HIV have become substantially more affordable over the years, prices for insulin have increased in the last century. The scientists who discovered insulin exactly one hundred years ago were given the Nobel Prize for Medicine, not just for their discovery, but because they chose to sell the rights to the medicine for just US$1, in the spirit of making insulin accessible to everyone in need. However, over the past century, three corporations moved in to dominate the insulin market almost exclusively and abused their monopoly position to drive up prices in some countries including the Unites States, UK, Finland and New Zeland, year after year. The cost to produce insulin is calculated to be between £55 and £102 per patient per year while the median global price of the insulin commonly used in most MSF projects is four times this, up to £220. Today more than half the people, who need the medicine, can’t actually get it. You can read more about why insulin remains out of reach here.
We also welcomed back Gurpreet Arora last month, who was on a nine-month mission in South Sudan, where he worked as a medical doctor in Mundri. MSF supports a primary health centre in Mundri town and runs community health posts in remote locations around Mundri. In April last year, one of our mobile medical teams in Mundri was subjected to a violent armed robbery, which forced us to suspend all activities in the area for several weeks. Splintered by conflict, South Sudan struggles to meet the essential needs of its people. Civilians in South Sudan have borne the brunt of over five years of conflict. Two million have fled into neighbouring countries, and another two million are displaced within its borders. Do let us know if you wish to know more about our project from Gurpreet. From treating patients with limited infrastructure to living in tents where temperatures can reach up to 41 degrees, he has a lot to share!
Year in pictures
Each year, we publish a series of images selected from thousands of photos from across the movement to reflect on the various contexts we work in. These 54 pictures of the year make up just a part of what our teams see and do every day. Take a look!
27-year-old Rohingya woman Sawkina recovers from a broken leg. Although she was born and raised in Malaysia, she does not have Malaysian nationality. As a divorced woman in a conservative society, she has to rely on herself and her parents to support her and her 13-year-old daughter. Malaysia, April 2019. Photo: Arnaud Finistre
We thank everyone who applied for MSF’s media fellowship this year! We do understand the application process was tedious this time around and we appreciate everyone who took the time and effort to submit their application. We are currently going through all the applications received and will get back to you shortly. You can find more details about our previous fellow and the stories she worked on here.
We also thank everyone who tuned in to our facebook live last week where we discussed Conflict, Epidemics and Migration with our former international president Unni Karunakara. If you missed it, you can watch it here. We plan to have another live in February as part of our Crises in Focus series covering various humanitarian issues across the world. You can follow us on facebook for more updates. Stay tuned!
Until next time.