Russia needs a government programme for hepatitis

The issue of a programme for treatment of
hepatitis was raised by Vladimir Chulanov, head of the Centre for Monitoring
Hepatitis at a press conference organised by Argumenti I Fakty to coincide with
World Hepatitis Day. Dmitry Kononov, chairman of an inter-regional non-governmental
organisation concerned with hepatitis “Together
against hepatitis”, said that access to treatment for hepatitis patients was discussed
in the Public Chamber in November 2010. At present there is no programme in
Russia for patients with viral hepatitis, apart from for specific groups of
patients such as those with HIV. Hepatitis above all affects young people of
working age, and while today there are drugs which treat the illness, they are
not accessible because of their high cost. In some cases treatment can cost 1
million roubles a year, Mr Kononov said. In Europe and the US the state bears
all or part of the costs of treatment. A programme of this sort is about to
start in Ukraine.


In Russia there is a high incidence
of hepatitis – 13-16 cases per 100,000 per annum. Chulanov said that about 3
million Russians suffer from hepatitis B and at least 650,000 of them require
urgent treatment. He also said that he thought that over the past ten years the
incidence of hepatitis C has increased considerably, to about 40 cases per
100,000 each year. Most affected are the north-western and south-eastern
federal districts, with about 5 million people across Russia infected with
hepatitis C and needing treatment. About 73 million people have been vaccinated
against hepatitis, but this does not solve the problem, said Chulanov.
Screening has also helped, such as for blood donors, pregnant women,
in-patients and health workers. But this has led to overloading of the
polyclinics where treatment is provided. Other problems are a lack of awareness
and lack of motivation to seek treatment among patients, no fixed standards for
diagnosis and a lack of equipment for it. In addition the costs of diagnosis
are not covered by the state programme and not all polyclinics are able to
check whether a patient is infected. Patients have to be referred to a private
diagnostic centre, and this is expensive for the patient.


Chulanov stressed that a state
programme and a federal register of those with the infection are needed. The
register would facilitate knowledge of the numbers of people affected, and ways
of treating them. He thought this was the only way to have a comprehensive
system of government support. Professor Achkasova, Chair of the Public
Chamber’s commission on healthcare and ecology, said it is essential to
increase funding for research into the epidemiology, prevention and treatment
of hepatitis, as well as to step up government support for domestic production
of antiviral drugs needed by people infected with hepatitis B and C, and of
relevant laboratory equipment and diagnostic kits, so as to reduce dependence
on expensive imported products. These were some of the recommendations during
the hearings on this subject at the Public Chamber last November. Today, every
12th member of the world population is infected with hepatitis B or
C, said Konovov. They risk succumbing to cancer or cirrhosis of the liver. So
the first
World Hepatitis Day is an important step in informing
the public about the illness. People need more information about it, and about
how it is transmitted and treated. The inter-regional organisation plans to
open a hot line providing counselling for sufferers and information on where to
get help. It also plans a series of seminars and conferences  at which sufferers can hear about the latest
developments in diagnosis, prevention and treatment from leading specialists in
the field.

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