Blitz Bureau
NEW DELHI: There is a category of disease that public health people call silent, and viral hepatitis is its textbook case. Hepatitis B and C can sit in a liver for two decades without producing a symptom worth mentioning, and then present as cirrhosis or liver cancer at a stage where treatment is expensive and outcomes are poor. A disease like that cannot be found by waiting for patients to arrive; it has to be gone out and looked for. Which is what makes the figures from India’s National Viral Hepatitis Control Programme worth pausing over: by March 2026, the programme had screened roughly 21.06 crore people and treated about 6.12 lakh hepatitis B and C patients across 1,153 treatment sites.
Set that against how the programme began. Launched in 2018, the NVHCP set out to do something that health systems in far richer countries have struggled with — build a national screening, diagnosis and free-treatment pathway for an infection whose sufferers mostly do not know they have it. Twenty-one crore screenings is a number of the same order as the entire population of Brazil. The treatment figure is smaller by design: most people screened do not have the infection, and the value of the screening lies precisely in ruling them out cheaply so that the expensive part of the system is reserved for the 6.12 lakh who need it.
Found late, treated dearly: hepatitis B and C can progress silently for two decades. The economics of the programme rest on catching infection before the liver damage that makes treatment expensive.
A screening programme is a bet that finding a disease early is cheaper than treating it late. At 21 crore tests, India has placed one of the largest such bets in the world.
At a Glance
• Programme: National Viral Hepatitis Control Programme, launched 2018
• Screened: about 21.06 crore beneficiaries by March 2026
• Treated: about 6.12 lakh hepatitis B and C patients
• Network: 1,153 treatment sites nationwide
• Why it matters: chronic hepatitis is typically asymptomatic for years before cirrhosis or liver cancer
The clinical case for the effort is unusually strong. Hepatitis C is now curable in the large majority of cases with a twelve-week course of direct-acting antivirals, and generic manufacture — much of it Indian — has brought the price of that course down by orders of magnitude from where it stood a decade ago. Hepatitis B is not curable, but it is controllable with antiviral therapy that dramatically reduces the risk of progression, and it is preventable by a vaccine given at birth. India therefore has, in one disease area, all three of the tools that public health rarely gets together: a cheap test, an affordable cure and a working vaccine.
The challenge that remains is the same one every screening programme faces at scale, and it is worth naming plainly: linkage to care. Screening 21 crore people creates value only to the extent that everyone who tests positive is actually traced, confirmed, started on treatment and followed to completion — a chain with several places to drop out, particularly for migrant workers and people far from a treatment site. The constructive path forward is to shift the headline metric from tests conducted to treatment courses completed, publish site-level linkage rates so that districts can see where the chain breaks, and continue expanding treatment sites towards the district hospitals and community health centres where the people who test positive actually live. India has already done the hardest and least glamorous part, which is finding the patients. Finishing the job is a logistics problem, and logistics is something the country has repeatedly shown it can solve.
