The Sikkim State Viral Hepatitis Control Program’s Implementation in line with the National Program is of crucial importance but is in a deplorable condition, as services for patients seeking viral hepatitis testing and treatment are delayed, neglected, and compromised. Such delays has only resulted in deaths that are avoidable. In Sikkim, the said program was launched in August 2019, by Dr. M.K Sharma, Health Minister. During the launching, the Health Minister along with State Health Department officials assured their commitment for;
1. Robust implementation of viral hepatitis testing and treatment in the state
2. Establishment of Viral load testing lab within the state
3. To provide necessary human resources for robust implementation of the program. As of today, even after a lapse of 2 years, the assurance given has not translated into reality, as the supposedly free viral hepatitis program remains a rather compromised health chapter in-terms of actual implementation.
It is unfortunate to make mention, that the state government is dependent on North Bengal Medical college (NBMC) for viral load test for Hepatitis C and DNA count for Hepatitis B, whereby patients are compelled to make travels to Siliguri for such diagnostics while some without any option had to resort to undergoing the diagnostics in private sector, purely out-of-pocket expenses incurring huge financial burden to patients who are from poor economic background.
SDUF has expressed such challenges of outsourcing viral load testing from the NBMC during the launch of the Free Hepatitis program and the Minister of Health Mr. M.K Sharma assured the establishment of a viral load testing lab within the state in August 2019. Yet, the assurance given only remains a mere “Lip Service”.
Finally, after continuous demand, the viral load test for Hep C and DNA count for Hep B was established, but unfortunately the test is only conducted once a week with minimal number of patients. Such limited services still result in low number of testing and low number of patients initiated on treatment. The planning and action of the government only shows the lack of urgency, and that the concern of the public is not considered a priority by the Health Department.
After 2 yrs of launching the program, the services is just limited to STNM hospital, Gangtok and people have to travel from other parts of the Sikkim to SNTM hospital, Gangtok and the patients has to visit STNM hospital 6 to 7 times till the patients completes the treatment.
Such a scenario and ignorant attitude of the Government only create barriers and gaps for vulnerable and low income communities from accessing free hepatitis programs, which will further lead to more infection and unfortunate deaths.
The lackadaisical attitude of the government only shows how clueless the department is towards scaling up the program. It is high time, the “deaf department” listens to the voice of the affected and impacted communities/organisation who are ever willing to provide assistance, guidance and support to achieve its collective goal to “Eliminate Viral Hepatitis” in Sikkim. Due to the poor planning and failure on scaling up testing & treatment, it has resulted in expiry of approximately 4671 bottles of Hepatitis B and Hepatitis C drugs received from the National Program.
Many people have lost their lives in the past without access to these Hep B & C drugs and it is a crime that this very expensive life saving drug was made to expire in the godown of the state Government.
Currently, patients under the Hepatitis B and C treatment will face drug shortage if the procurement doesn’t happen before 20 August 2021 and such major lapse occurred due to the poor coordination and planning and if this patients do not receive the required Hepatitis B & C drugs on time, it will serve as a huge setback on their wellbeing and health. The viral Hepatitis Program in the state has further worsened by the COVID 19 crisis but one particular health crisis should not affect other health crises.
Both pandemic should be addressed with equal priorities so that the people are not put in risk of infection and deaths. It is very discouraging to witness how government has neglected the viral hepatitis program and left people’s lives at lurch by engaging the nodal officer of NVHCP in COVID 19 duty – the person who is sole incharge of the NVHCP program implementation in the state and even the worst is that Government has failed to appoint the dedicated medical officer for the viral hepatitis control program.
The incompetence and lack of leadership in the government has turned the viral hepatitis control program completely in a tormented state. Sikkim drug users’ forum and its members as a beneficiary of the services and support group for the vulnerable and marginalised community have express the concern, challenges and also provided all the support and expertise on effective implementation of the hepatitis program but it is unfortunately that the Health Minister and the officials of the health department failed in its commitment, lack leadership that was promised during the launching and forgot the very goal to prevent morbidity and mortality resulting out viral hepatitis.
Sikkim Drug Users’ Forum therefore urge the Honorable Chief Minister, Mr. Prem Sing Tamang and Health Minister, Dr. M.K Sharma for their kind attention seeking immediate intervention on the proper implementation of the program and to demonstrate their leadership to the viral hepatitis program in the state, to achieve the collective goal to eliminate viral hepatitis in Sikkim by 2030.