Modi’s India wants to control hepatitis. Why are police beating protesters seeking treatment?
- The disease disproportionately affects HIV-positive people, like the protesters calling for the government’s free hepatitis treatment programme to resume
- While Covid-19 has diverted health resources, those in the sector say the programme has only been operational for some six months since February 2019
On July 28, World Hepatitis Day, the New Delhi health ministry asked Loon Gangte and members of the Delhi Network of Positive People (DNP+) – a group of people and advocates who live with HIV – to come to the capital’s Lok Nayak Jai Prakash Hospital.
Gangte, the president and a founding member of the DNP+, knew the group had not been invited for a government event to mark the occasion – not once in his 20 years of activism as a HIV-positive person had he been asked to attend one. Rather, he had been told the central government’s free hepatitis treatment programme was set to resume. Late that afternoon, however, when the clinic remained closed and the 30-odd DNP+ members were told to return home, Gangte made up his mind. It was time to take action.
On July 29, Gangte and the DNP+ members returned to the hospital with some tarpaulin for a sit-in. They planned to protest there, day and night in the capital’s muggy heat, until the clinic reopened. They followed Covid-19 regulations, including wearing masks and sitting at a distance from each other.
A group of paramilitary personnel showed up in front of the protesters one afternoon, but left without incident. Then, on August 1, the Delhi police arrived. A video shared by the group on Facebook showed the police pulling some protesters by their hair, and pushing others to the ground, as they detained four DNP+ members. When their colleagues tried to shield those who had fallen down, the police roughly shook them off.
“The Delhi police are experts at beating without leaving marks of violence,” said Gangte, who was freed late that evening. “They punched me on my ribs. Outwardly, you cannot see anything, but the pain is so intense that I could not get out of bed all day.”
In July 2018, the Modi government announced free testing and treatment for Hepatitis B and C, the two most widespread forms of the virus. On its website, the National Viral Hepatitis Control Programme indicates the plan covers “the entire gamut” of hepatitis, including the A, D and E varieties. There are 40 million people living with Hepatitis B and between 6 million and 12 million with Hepatitis C, according to government estimates. In its commitment to the United Nation’s Sustainable Development Goals, India has pledged to eliminate Hepatitis B and C by 2030.
On World Hepatitis Day in July, days before Gangte and his DNP+ colleagues were beaten and arrested, Modi’s health minister Dr Harsh Vardhan was among a number of high-profile government officials who took part in an online conclave on the need to combat hepatitis, particularly during the Covid-19 pandemic.
“While the mortality due to Covid-19 is approximately 2 to 3 per cent, and most cases are largely asymptomatic, it is important to create awareness about the higher risk of both morbidity and mortality faced by people with co-morbidities like … chronic liver disease,” Vardhan said at the event, adding that an estimated 80 per cent of people with chronic viral hepatitis did not know they were infected.
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To observers, the conclave served as yet another reminder of the BJP’s mastery of saying the right thing – and doing the opposite. Those in the sector say there has been no transparency over how many clinics are currently operating under the programme, while those known to be open have been barely operational during India’s lockdown, with the implication that the pandemic is taking up all available health resources.
“There is no data on the number of clinics or centres currently operating under the programme,” said Yashwinder Singh, a representative on the steering committee of the National Viral Hepatitis Control Programme.
“The government has not shared data though I am on the committee, but we know that most hospitals have been converted into Covid-19 centres and the hepatitis clinics are closed,” he said, adding that Hepatitis B treatment had not yet started, and the clinics were only providing Hepatitis C support.
Others say the national hepatitis programme has only been operational on the ground for between four and six months since its star-powered February 2019 launch by Bollywood star Amitabh Bahchan, who has spoken about contracting and living with Hepatitis B.
Eldred Tellis – the founder of Sankalp Rehabilitation Trust, which provides treatment, safe injections and rehabilitation programmes for drug users – said the programme only began last October in the city of Pune.
“In Mumbai, I was told there were no testing kits until December last year. Then the country locked down in March. We managed to enrol our first 10 clients for treatment in June after really pushing,” Tellis said. “There is no advertising for this programme, no one knows about it.”
Mahendra Kendre, who works with the state health service of Maharashtra – where both Pune and Mumbai are located – has maintained that the free hepatitis treatment began right after the February 2019 launch, and service has been uninterrupted. The director of state health services in West Bengal said the hepatitis clinics were functional, but has remained silent about whether they were functional during the lockdown, which is still enforced on certain days in the state. The central and Delhi governments did not respond to requests for comment.
The hepatitis clinic at Lok Nayak Jai Prakash Hospital, however, reopened in early August. “If our beating means that some people can access treatment, then that is something,” said Gangte from the DNP+.
