Predictions: 10 years from now, hepatitis C deaths will double

Viral hepatitis has become a real challenge to humanity. In terms of growth rates and the scale of its spread in the world, viral hepatitis far exceeds AIDS and even influenza and acute respiratory viral infections.

According to WHO, about 180 million of the world's population (about 3%) have chronic hepatitis B virus infection, another 400 million live with hepatitis B, while 40 million are HIV/AIDS patients. And if we take into account that not all cases of the disease are registered due to the latent form of hepatitis C, we can talk about a viral hepatitis pandemic. Its consequences are catastrophic: every year 500-700 thousand people die from hepatitis B in the world, and another 350 thousand die due to liver damage by the hepatitis C virus. 57% of cases of liver cirrhosis and 78% of cases of primary liver cancer are caused by hepatitis B or C viruses. Experts' forecasts are no less pessimistic: in 10-20 years, mortality from hepatitis C will increase by 2 times and will significantly exceed mortality from HIV infection. This problem will become a major health problem. But the worst thing is that the increase in the number of patients with chronic viral hepatitis throughout the world is due to young people aged 15 to 35 years.

High risk area

The epidemic of parenteral viral hepatitis in Ukraine has its own peculiarities. The "gentle killer" is disguised not only in the body of patients, but in official statistics, until June 2009, it recorded only acute forms of HB and HS. Now the situation has changed, but the official count of patients is only a mini-copy of the real situation in the country. After all, testing for viral hepatitis C is not yet mandatory. But even the meager statistical data are alarming - for example, in Ukraine, a fairly high level of hepatitis B morbidity has been recorded (7.03 per 100 thousand people) - for comparison, in the USA and EU countries these figures do not exceed 1.0 - 3.0 per 100 thousand people. And since there are 5-6 anicteric forms of hepatitis B per 1 registered form, experts predict that more than 1 million hepatitis B virus carriers live in our country. Vaccination of children against hepatitis B began in Ukraine in 2006, so everyone born earlier is at risk of this virus. Not to mention that we are generally powerless against hepatitis C due to the lack of vaccines. This is especially true for risk groups - medical workers, employees of special services, gastroenterological patients, etc. And given the lack of public awareness of the spread of hepatitis viruses, every citizen of Ukraine is at risk.

When Silence Is Not Golden

Another national peculiarity of the viral hepatitis problem was that public organizations were the first to actively discuss it. They were the ones who “awoke” society, and then the authorities, who finally supported the initiative to develop the Concept of the corresponding target program. This initiative was first voiced by activists of the All-Ukrainian Public Organization “Stop Hepatitis”, and with their direct participation, the Ministry of Health of Ukraine developed the State Targeted Social Program for the Prevention, Diagnosis and Treatment of Viral Hepatitis for the period up to 2016. The program turned out to be far-sighted and comprehensive. The only thing it lacked was a financial support point. The Ministry of Health of Ukraine made a request that funds for the fight against hepatitis be allocated in the 2012 State Budget, but they were never allocated. Therefore, the onset of the hidden epidemic in Ukraine continues. What will we put on the other side of the barricades? Limited capacity of medical institutions to conduct virological research or even less ability of our compatriots to buy expensive antiviral drugs for the treatment of chronic viral hepatitis?

The first steps are not enough

Over the past 5 years, the Verkhovna Rada Committee on Healthcare has received numerous appeals from citizens, groups, regional councils, and non-governmental organizations regarding the grave situation in Ukraine with viral hepatitis. In response to each of these appeals, measures were taken. The problem of viral hepatitis is becoming an important medical and social problem, the significance of which is due, in particular, to the high frequency of chronicization with the often latent course of acute forms of the disease. Viral hepatitis B and C lead to the development of liver failure, cirrhosis, and liver cancer. The widespread prevalence of chronic hepatitis among the population, in particular, hepatitis C, can have catastrophic consequences.

The specified problem can be solved only in a comprehensive manner, by developing and adopting a relevant State Program with real budgetary filling. Unfortunately, there is no Program to combat viral hepatitis in Ukraine. The activities envisaged by the Concept "On approval of the Concept of the State Targeted Social Program for the Prevention, Diagnosis and Treatment of Viral Hepatitis for the period up to 2016", approved by the Cabinet of Ministers order of 9.03.2011 No. 206, have not been implemented. In particular, one of the points of this order of the Cabinet of Ministers instructed the Ministry of Health of Ukraine together with the interested central executive authorities to develop and submit to the government within three months a draft State Targeted Social Program for the Prevention, Diagnosis and Treatment of Viral Hepatitis for the period up to 2016. That is, the government must approve the specified Program back in June - July 2011. In addition, the adoption of this Program would allow the regions of Ukraine to develop and approve relevant regional programs at the local level and attract funds from local budgets to resolve this important issue. Unfortunately, according to the current legislation, without a corresponding Program for combating viral hepatitis approved by the government or the Verkhovna Rada of Ukraine, it is impossible to allocate funds for this in the state budget of Ukraine.

In 2011, the State Budget of Ukraine allocated 4 million UAH for the purchase of medicines for the treatment of children with chronic viral hepatitis - in fact, only 1 million 337 thousand 700 UAH was spent from this amount. The Law of Ukraine "On the State Budget of Ukraine for 2012" of the Ministry of Health of Ukraine allocated funds in the amount of 8 million UAH for this event.

Waiting for change

The topic of viral hepatitis in Ukraine has been heard for several years. Since the development of the State Program for Combating These Diseases and the approval of the Concept, things have been moving along quite quickly. But at the stage of making decisions aimed at providing real help to our fellow citizens, everything has stopped.

It seems that officials do not want to hear and talk about the problems associated with viral hepatitis. Of course, they can talk about these problems, but they cannot work out a solution on which the lives of hundreds of thousands of Ukrainians depend!

It is not clear why officials do not realize the catastrophic consequences of inaction regarding viral hepatitis. These consequences will have to be overcome very soon, although even from an economic point of view, prevention is much cheaper than fighting them. It is time to realize this and allocate funds for the treatment of patients! Therefore, the formal part of the process called "State Program for Combating Viral Hepatitis" has been completed. Now we need it to be approved by the Minister of Health of Ukraine and are waiting for a positive decision by the people's deputies of Ukraine regarding its financing. However, these are not such large expenses on a national scale.