S Ahmad
India is systematically breaking down healthcare barriers to achieve its 2030 goal of combating hepatitis. National Viral Hepatitis Control Program has adopted a health systems approach and integrated with various national programs to prevent infection and provide services including free drugs and diagnostics to the people affected with the disease.
By integrating prevention, vaccination, screening and free treatment, India is attempting to transform hepatitis control from a fragmented health response into a comprehensive public health mission.
For decades, viral hepatitis has remained one of India’s most under-recognised public health challenges. Unlike many infectious diseases that trigger immediate alarm, hepatitis often progresses silently, damaging the liver over years before symptoms become apparent. By the time many patients seek medical attention, they may already be suffering from cirrhosis, liver failure or liver cancer.
Recognising this hidden burden, the Government of India launched the National Viral Hepatitis Control Programme (NVHCP) in 2018 with an ambitious objective: to systematically prevent, detect and treat viral hepatitis while aligning with the global goal of eliminating hepatitis as a public health threat by 2030.
The programme represents a significant shift from treating hepatitis merely as an isolated clinical disease to addressing it as a comprehensive public health issue requiring coordinated intervention across prevention, diagnosis, treatment and surveillance.
Understanding the Disease
Hepatitis refers to inflammation of the liver. Although excessive alcohol consumption, certain medicines, toxins and autoimmune disorders can also damage the liver, viral infections remain among the most significant causes.
Five major hepatitis viruses affect humans—Hepatitis A, B, C, D and E—each differing in transmission, severity and treatment options.
Hepatitis A and E generally spread through contaminated food and water, making sanitation and safe drinking water the primary preventive measures. Most patients recover completely with supportive care.
Hepatitis B and C, however, present a far greater public health challenge because they frequently become chronic infections, increasing the risk of liver cirrhosis and liver cancer.
Hepatitis B is transmitted mainly from mother to child during birth, through infected blood and body fluids. Fortunately, it is vaccine-preventable, making immunisation the strongest defence.
Hepatitis C spreads primarily through unsafe injections, contaminated blood products and sharing of needles. Unlike Hepatitis B, there is no vaccine, but modern Direct-Acting Antiviral (DAA) medicines can cure nearly all patients within 12 to 24 weeks.
Hepatitis D occurs only in people already infected with Hepatitis B, making Hepatitis B vaccination indirectly protective against it as well.
The National Viral Hepatitis Control Programme
The launch of NVHCP in 2018 marked India’s first nationwide, integrated strategy dedicated exclusively to combating viral hepatitis.
Rather than functioning as an isolated vertical programme, it operates through a health systems approach, integrating multiple national health missions and existing healthcare infrastructure.
Its principal objectives include:
-
Increasing awareness about hepatitis prevention.
-
Expanding early diagnosis through widespread screening.
-
Providing free diagnostics and treatment.
-
Preventing transmission through vaccination and safe medical practices.
-
Building a digital monitoring system for patient management.
Importantly, the programme covers all five hepatitis viruses, though treatment efforts primarily focus on Hepatitis B and C, where long-term disease burden is greatest.
Prevention Before Treatment
One of the strongest pillars of India’s hepatitis strategy is prevention.
For Hepatitis A and E, emphasis remains on improving sanitation, access to clean drinking water and hygiene practices. Since both viruses spread through contaminated food and water, investments in sanitation indirectly contribute to hepatitis control.
For Hepatitis B, vaccination remains the most effective intervention.
Through the Universal Immunisation Programme, newborns receive the Hepatitis B birth dose within 24 hours of birth, followed by additional doses at 6, 10 and 14 weeks.
This timely birth dose is particularly important because mother-to-child transmission accounts for a significant proportion of chronic Hepatitis B infections.
Healthcare workers and high-risk populations are also covered through vaccination initiatives integrated with the National AIDS Control Programme.
Expanding Screening and Early Detection
Early diagnosis significantly improves treatment outcomes while reducing further transmission.
India’s strategy therefore focuses on expanding screening services through multiple healthcare programmes.
Pregnant women undergo universal Hepatitis B screening under maternal health programmes.
High-risk populations are screened through the National AIDS Control Programme.
Blood donors testing positive for Hepatitis B or C are linked with treatment facilities.
The programme also leverages molecular diagnostic infrastructure established under the National Tuberculosis Elimination Programme, allowing existing laboratory resources to serve multiple public health objectives.
Such convergence not only reduces duplication but also improves cost efficiency across health programmes.
Free Diagnosis and Treatment
Perhaps the most significant intervention under NVHCP has been the provision of free diagnostics and medicines.
Patients diagnosed with chronic Hepatitis B receive antiviral medicines according to national treatment guidelines.
Those suffering from Hepatitis C benefit from Direct-Acting Antiviral drugs, capable of curing nearly all patients within three to six months.
The availability of affordable generic medicines has considerably reduced treatment costs, making large-scale public treatment financially viable.
Instead of restricting services to tertiary hospitals, diagnosis and treatment are gradually expanding to district hospitals and local health facilities, bringing care closer to communities.
Digital Patient Management
Unlike traditional paper-based disease programmes, NVHCP incorporates a paperless monitoring system through the NVHCP Management Information System (MIS).
The digital platform records patient registration, diagnosis, treatment and follow-up, enabling better programme monitoring while reducing administrative delays.
Digital health records also help policymakers assess treatment coverage, identify service gaps and allocate resources more efficiently.
Integration Across Health Programmes
A defining strength of India’s hepatitis strategy lies in its integration with existing national health programmes rather than creating parallel systems.
Several flagship programmes contribute directly to hepatitis control:
-
Maternal and child health services ensure screening of pregnant women and newborn vaccination.
-
Universal Immunisation Programme provides nationwide Hepatitis B vaccination.
-
National AIDS Control Programme screens vulnerable populations and supports vaccination.
-
National Tuberculosis Elimination Programme contributes laboratory infrastructure.
-
Blood transfusion services facilitate identification and referral of infected donors.
This integrated model improves efficiency while maximising the use of existing healthcare infrastructure.
Understanding Disease Burden
Surveillance remains central to effective public health planning.
According to India’s 2021 HIV Sentinel Surveillance, approximately 0.85 per cent of surveyed individuals tested positive for Hepatitis B, while 0.29 per cent tested positive for Hepatitis C.
Although these percentages appear relatively small, they represent millions of individuals given India’s population size.
Early identification therefore remains critical to preventing long-term complications and reducing disease transmission.
Public Awareness and Citizen Support
Medical interventions alone cannot eliminate hepatitis.
Public awareness regarding transmission, vaccination, hygiene, safe injection practices and early testing remains equally important.
To strengthen community outreach, the government operates a national toll-free helpline (1800-11-6666) that provides information about hepatitis prevention, diagnosis, treatment and available healthcare facilities.
The helpline also assists patients in locating service delivery centres established under the National Viral Hepatitis Control Programme.
Expanding Care, Closing Gaps — Can India Eliminate Hepatitis by 2030?
The National Viral Hepatitis Control Programme (NVHCP) represents far more than a disease-specific intervention; it reflects an evolving philosophy of public healthcare that emphasises integration, decentralisation and universal access. Rather than building a parallel healthcare structure, the programme leverages India’s existing health architecture, making hepatitis prevention and treatment part of routine public health delivery.
Bringing Treatment Closer to Communities
One of the programme’s most significant achievements has been the gradual decentralisation of services. Initially concentrated in tertiary hospitals and specialised centres, hepatitis diagnosis and treatment are increasingly available through district hospitals and lower-tier public health facilities.
This shift is particularly important for rural and semi-urban India, where patients often delayed testing because specialist services were available only in distant cities. By moving services closer to communities, the programme seeks to reduce both financial and geographical barriers to care.
Free diagnostic facilities and medicines have further strengthened accessibility. Chronic Hepatitis B patients receive antiviral therapy according to national treatment guidelines, while those diagnosed with Hepatitis C are provided Direct-Acting Antiviral (DAA) medicines that can cure nearly all patients within 12 to 24 weeks. The availability of affordable generic medicines has made this large-scale treatment strategy economically feasible, significantly reducing the burden on patients who might otherwise face catastrophic healthcare expenditure.
Building on Existing Health Infrastructure
India’s hepatitis strategy stands out because it avoids duplication. Instead of creating new institutions, it strengthens coordination among existing national health programmes.
Maternal and child health services ensure that pregnant women are screened for Hepatitis B and that newborns receive timely vaccination. The Universal Immunisation Programme provides routine Hepatitis B vaccination across the country. The National AIDS Control Programme screens high-risk groups and supports vaccination for healthcare workers and vulnerable populations. Blood transfusion services identify infected donors and facilitate referral for treatment, while the National Tuberculosis Elimination Programme contributes molecular diagnostic capacity by allowing hepatitis testing through existing laboratory infrastructure.
Such convergence improves efficiency, optimises public investment and strengthens the overall health system rather than creating isolated disease-specific programmes.
Digital Monitoring for Better Governance
The adoption of a paperless Management Information System marks another important reform. Digital patient records enable healthcare providers to track diagnosis, treatment and follow-up while helping administrators monitor programme performance in real time.
Digital monitoring also improves accountability by identifying gaps in service delivery, measuring treatment completion rates and facilitating evidence-based policy decisions. In an increasingly data-driven healthcare environment, such systems are becoming indispensable for effective public health management.
Awareness: The Missing Link
Despite improvements in treatment and diagnostics, awareness remains one of India’s biggest challenges.
Millions of individuals infected with Hepatitis B or C remain unaware of their condition because these diseases often remain asymptomatic for years. Unlike acute infections that produce immediate illness, chronic hepatitis quietly damages the liver until irreversible complications develop.
Consequently, public education must become as important as clinical intervention. Greater awareness regarding vaccination, safe medical practices, blood safety, hygiene, early screening and treatment availability is essential if India is to meet its elimination targets.
The government’s toll-free hepatitis helpline and community awareness initiatives are valuable beginning points, but sustained behavioural change requires continuous engagement through schools, community health workers, civil society organisations and primary healthcare providers.
The Challenge of Elimination
The World Health Organization has set ambitious targets for eliminating viral hepatitis as a public health threat by 2030. Achieving these goals requires substantial reductions in new infections and hepatitis-related mortality.
India’s progress since 2018 has been encouraging. Universal vaccination, expanded screening, free treatment, programme convergence and digital monitoring have created a strong institutional foundation. Yet considerable challenges remain.
Large sections of the population continue to lack awareness about hepatitis transmission and prevention. Birth-dose vaccination coverage must become truly universal, particularly in remote and underserved areas. Screening needs further expansion to identify asymptomatic carriers before irreversible liver damage occurs. Continued investment in laboratory infrastructure, trained healthcare personnel and uninterrupted medicine supply chains will remain essential.
The challenge is therefore not merely medical but administrative, logistical and behavioural.
An Indian Express Assessment
India’s hepatitis strategy reflects a broader transformation in public health governance—from fragmented interventions towards integrated health systems. The National Viral Hepatitis Control Programme demonstrates how convergence across multiple national programmes can improve efficiency while expanding access to healthcare.
The emphasis on free diagnostics and treatment reflects an important commitment to equity. Hepatitis disproportionately affects economically vulnerable populations who are least able to afford lifelong treatment. Public financing therefore serves both humanitarian and economic objectives by preventing costly complications such as liver cirrhosis and liver cancer.
Equally noteworthy is the programme’s integration with digital health infrastructure. Real-time patient monitoring, paperless reporting and coordinated service delivery indicate a shift towards evidence-based public health administration.
However, policy success cannot be measured solely by programme design. The real test lies in implementation at the last mile. Vaccination must reach every newborn, screening must become routine rather than exceptional, and treatment services must remain consistently available across all districts. Public awareness campaigns must evolve beyond periodic messaging into sustained community engagement.
The fight against hepatitis also illustrates a broader lesson for India’s healthcare system: prevention is invariably more effective—and far less expensive—than treating advanced disease. Investments in vaccination, sanitation, safe healthcare practices and early diagnosis yield returns that extend far beyond hepatitis control, strengthening the overall resilience of public health.
The Road Ahead
India’s campaign against viral hepatitis is steadily moving from policy intent to measurable public health action. The expansion of free screening, universal vaccination, affordable treatment, integrated health systems and digital monitoring provides a robust framework for tackling one of the country’s most persistent yet neglected diseases.
Eliminating hepatitis by 2030 remains an ambitious objective, but it is no longer an unrealistic one. Success will depend not only on government programmes but also on public awareness, healthcare worker engagement, community participation and continued political commitment.
Ultimately, India’s battle against hepatitis is not simply about controlling a virus. It is about strengthening primary healthcare, preventing avoidable deaths, reducing long-term healthcare costs and ensuring that every citizen—regardless of income or geography—has access to timely diagnosis, effective treatment and the opportunity to live a healthier life.
The article is based on the inputs and background information provided by the Press Information Bureau (PIB). Author is Writer, Policy Commentator. He can be mailed at kcprmijk@gmail.com
Comments are closed.