IMPHAL, January 28: A day-long state-level consultation on improving access to treatment of hepatitis C under the Manipur State Illness Assistance Fund (MSIAF) today recommended that HIV positive people and those who are on ART be included in the eligibility criteria for accessing benefits under the scheme.
The consultation was organised by the Community Network for Empowerment (CoNE) and state directorate of health services. It was attended by representatives of TREAT Asia/amfAR, Bangkok, UN AIDS International Treatment Preparedness Coalition (ITPC), South Asia, Medicine Sans Frontier (MSF), community-based organisations and pharma companies like Merck, Zydus.
Speaking on the occasion as presidium member, Dr S Mema Devi, additional director, public health service, directorate of health services, said that the treatment of Hep-C was included under MSIAF from October 2013. “The amount does not actually cover the whole amount incurred by the patient family at the time of treating the patient. Moreover, the amount that is sanctioned under the scheme is also in the form of re-imbursement. This is not actually realistic in the real sense of the term,” she stated.
She further informed, “Out of the total number of patients coming for re-imbursement under the scheme, 14% are Hep-C patients, which is very high”.
W Khoibi Devi, deputy director of health services who was a resource person stated that for the fiscal year 2012-13, the number of patients who have received sanction from the state government under MSIAF is 202. “Unfortunately there were no Hep-C patients since it was not included under the provision of MSIAF then”.
“However this time a total of 203 patients has been sent for approval to the management committee and the final results are being awaited. From the total number of patients sent for approval, after screening, 29 Hep-C patients have also been included”, she added.
Deliberating on MSIAF, W Khoibi further stated that “Under the scheme, a patients belonging to BPL family with an annual income of Rs 25,000 will be entitled a one-time assistance upto a maximum of Rs 1.5 lakh as reimbursement of cost incurred in treatment of major ailments. The ailments eligible for receiving assistance under MSIAF scheme are cardiology & cardiac surgery; cancer; urology; nephrology; gastroenterology; orthopaedics; all major surgeries and medical investigations, ophthalmology, Dentistry, ENT”.
“Treatment of HCV is very costly (about Rs 3 lakhs) but the MSIAF ceiling is only Rs 1.5 lakhs. The main problem lies here. Possible solutions for these problems are cost reduction for medicine; special consideration for HCV patients and more awareness programme”, she maintained.
Speaking on the topic “Treatment scenario of HCV in Manipur”, Dr Kh Lokeshwar, assistant professor of JNIMS, stated, “We are focussing on HCV in the state as it comes along with one of the disease which is not curable till today (HIV). In-spite of the medical advancement Hep-C is not curable as of now in this world. Hep C is major issue in the state and the party responsible should focus on it with more intensity. Out of every 100 persons infected by Hep-C, 15 of them are free as the immune system of the body can kill the virus. 10 to 15% recovers by itself. HIV co-infection is more dangerous than mono infection,” he stated.
He further stated, “The rate of Hep-C is increasing among the MSMs. The state is still to have a proposal for mass screening of all risk groups and not only IDUs who are HIV+. Only then, we can have a concrete data on HEP-C scenario in the state. Requires dedicated large scale survey”.
In-spite of the availability of injection interferon and oral antiviral for Hep-C treatment, many of hep-c patients who are poor are left of treatment, as they do not have money to buy the medicines. “As of now treatment of hep-c is costly and only the affordable people are receiving the treatment”, he said adding “the rate of success as of now is 50-60 percent and we have a ray of hope”.
Highlighting the challenges in the state, he further informed that “We have technological drawbacks. We report late. The individual who comes for treatment is already seriously infected”. There is no harm in knowing the status and being treated early. Mass public awareness in this regard is very important, he said.
However, he went on to state that “Treatment with the best still has 20-30% relapse”.
The workshop also saw the attendance of members of various CBOs of the state including Project Orchid, CSD, HRA, DSSS, KRIPA Society, WAD, DNP+, HOPE, SDUCO, WREN, DOULOS, Merck etc. Khwairakpam Giten, Manager of Community and Policy, TREAT Asia/amfAR, Bangkok, Sushil Huidrom, State Coordinator, UN AIDS and Loon Gangte, Coordinator, ITPC, South Asia were also present on the occasion.