Hepatitis patients looking for a livelihood

Patients with hepatitis C are asking the State Duma to include funding for measures to combat this disease in the draft federal budget for 2023. There is no such clause in the document that passed the first reading, despite two instructions from the President of Russia “to provide for the necessary funding.” The patient association “Together Against Hepatitis” sent an appeal to the deputies with a request to comply with the instructions of the head of state. The Committee on Health Protection of the State Duma told Kommersant that by the second reading, which will be held on November 22, they hope to make changes. In the fight against hepatitis, according to deputy chairman of the committee Sergei Leonov, the deputies propose to direct the income from the excise tax on sugar-containing drinks.

The interregional public organization “Together Against Hepatitis” appealed to the State Duma Committee on Health Protection and the Committee on Budget and Taxes with a request to amend the draft law on the federal budget for 2023. The document passed the first reading on October 26, the second, according to the First Deputy Chairman of the State Duma Alexander Zhukov, is scheduled for November 22.

In its appeal, the patient organization indicates that the draft law does not provide for financing additional measures to combat chronic viral hepatitis C, despite the attention paid to this issue by the country’s top leadership. Patients note that back in April 2021, Vladimir Putin in his message noted the need for “additional measures” to combat hepatitis C, which “claims many young lives.” In July 2022, after a meeting of the Council under the Government of the Russian Federation on guardianship in the social sphere, a list of instructions aimed at combating hepatitis C was formed. On September 1 this year, a meeting of the Council for Strategic Development and National Projects was held. As a result, the President gave a number of instructions to the Cabinet, in particular, “taking into account the earlier instructions, to ensure the implementation of a set of measures aimed at combating hepatitis C and diabetes, providing for the necessary funding.”

Legislators have already found funds to fight diabetes. The State Duma adopted in the first reading amendments to the Tax Code, which introduced an excise tax on sugar-containing drinks. The excise tax will be 7 rubles. per liter and will be effective from January 1, 2023. Additional income from such payments may amount to about 35 billion rubles. in year. 10 billion, as Deputy Chairman of the State Duma Committee on Health Sergei Leonov (LDPR) told Kommersant, will be directed to the implementation of measures to combat diabetes.

“Such selective blindness in carrying out the president’s orders is surprising,” comments Nikita Kovalenko, chairman of Together Against Hepatitis. “I’m afraid that the Ministry of Finance underestimates the impact of hepatitis C on mortality and the economy in general.”

According to Mr. Kovalenko, “a large number” of foreign and domestic studies show that “huge budget expenditures” are associated with chronic viral hepatitis. Thus, among patients with hepatitis C aged 16 to 55 years, the number of patients with more than one chronic disease is two to five times higher than the corresponding figure among non-infected hepatitis viruses. These patients are prescribed multiple times more drugs, they often take sick leave. Chronic viral hepatitis doubles to four times the incidence of various malignancies, not even including liver cancer, is one of the causes of type II diabetes, and doubles the incidence of cardiovascular events. Cancer patients infected with chronic hepatitis viruses are two to three times more likely to have recurrences of malignant tumors.

Note that in Russia there is no exact data on the number of patients with hepatitis. About 700 thousand people are registered. According to the reference center for monitoring viral hepatitis of the Central Research Institute of Epidemiology of Rospotrebnadzor, from 3.5 million to 4.7 million people live with hepatitis C in Russia. And Vladimir Chulanov, chief freelance specialist in infectious diseases of the Ministry of Health, told reporters in July 2021 that “according to the calculations of many researchers, the population of people who could be infected is estimated at about 5.7 million people.” He noted that about 20% of this number of patients recover on their own, without treatment. However, most hepatitis C becomes chronic.

In addition, according to official figures, 45,000 Russians are infected with this virus every year. At the same time, as the experts of the Treatment Preparedness Coalition project (which monitors public procurement and availability of medicines) found out, in 2020 the Ministry of Health purchased only 20 thousand courses of drugs for hepatitis C. “Current treatment coverage does not even allow reducing the incidence of hepatitis C, and it will take more than 35 years to treat at least already identified patients. That is why the fight against hepatitis requires additional measures,” says the appeal of the patient organization. Nikita Kovalenko clarifies that, according to the plans of the Ministry of Health, 9.6 billion rubles will be required. for 2023 and 11 billion rubles. for 2024 and 2025.

“Indeed, there are already two instructions from the president, and by and large officials must fulfill them,” comments Alexei Kurinny, deputy chairman of the State Duma health committee, (KPRF) on Kommersant’s appeal. “At present, the allocation of such an amount is quite realistic, and I hope that This issue will be resolved by the second reading. Sergei Leonov clarifies that the same excise payments can become a source of funding: “At a meeting with Finance Minister Anton Siluanov, I raised this issue from the faction and asked that all the money from the introduction of the excise tax go to healthcare, including for additional treatment of patients with viral hepatitis. The Minister of Finance commented that they are ready to increase funding through excise, this will be decided by the second reading.”

Kommersant sent a request to the Ministry of Health, but at the time of publication did not receive a response.

Natalya Kostarnova