India Steps Up Efforts to Achieve Hepatitis Goals by 2030

Summary:
India has reaffirmed its commitment to achieving the global 2030 hepatitis elimination targets through stronger prevention, screening, early diagnosis and access to treatment under the National Viral Hepatitis Control Program. The country is expanding vaccination, community screening, decentralised testing and free antiviral care for eligible patients, while improving long-term monitoring for complications. Health authorities are also stressing responsible medication use to reduce liver and kidney damage, including avoiding unnecessary NSAIDs and antibiotics, strengthening prescription controls and promoting antibiotic stewardship. These combined efforts aim to reduce hepatitis-related illness and deaths while supporting India’s broader public health goals. 

India has renewed its commitment to achieving the global 2030 hepatitis elimination targets at a high-level side event of the United Nations General Assembly. Union Health Secretary Punya Salila Srivastava highlighted the country’s comprehensive, people-focused approach to healthcare. The strategy places emphasis on prevention, extensive screening, timely diagnosis and evidence-based treatment. At the same time, central health authorities stressed the importance of protecting organ health by preventing inappropriate medication use.

Strategic Roadmap for Hepatitis Elimination 2030

India is intensifying measures under the National Viral Hepatitis Control Program to support the achievement of the Sustainable Development Goals. Public health authorities are working toward eliminating hepatitis B and hepatitis C as significant public health concerns. Chronic viral hepatitis can remain unnoticed for many years without producing obvious symptoms. As a result, infections that remain untreated can eventually cause irreversible cirrhosis, portal hypertension and hepatocellular carcinoma.

To prevent these serious complications, national health programs have incorporated viral hepatitis services throughout primary, secondary and tertiary levels of healthcare. Universal hepatitis B birth-dose vaccination provides newborns with essential protection against transmission from mother to child. Routine screening during pregnancy also helps identify maternal infection at an early stage. Where necessary, healthcare workers provide both vaccination and immunoglobulin to protect infants.

Community outreach programs also conduct viral hepatitis screening camps in districts with high disease prevalence, helping connect people with undiagnosed infections to specialised medical services. The national strategy further focuses on ensuring fair access to diagnostic and treatment facilities. Government healthcare centres across Indian states provide eligible patients with direct-acting antivirals and nucleoside analogues at no cost. By decentralising treatment services, rural communities can receive regular medical care without having to travel long distances. This coordinated approach helps reduce illness and deaths among vulnerable populations.

Strengthening Screening, Diagnosis, and Free Antiviral Care

Identifying infection early is a critical part of effective viral hepatitis management. Healthcare institutions in India have therefore established decentralised testing facilities to detect people who may carry the infection without symptoms. Medical professionals use point-of-care rapid diagnostic tests as well as quantitative molecular testing to confirm active viral infection. Simplified treatment protocols also enable primary-care doctors to begin and supervise antiviral treatment more effectively.

Pan-genotypic direct-acting antiviral medicines can achieve sustained virologic response rates above 95% in people with hepatitis C. Standard 12-week oral treatment courses also generally have fewer adverse effects than older interferon-based treatments. For hepatitis B, doctors use high-barrier nucleoside analogues, including tenofovir and entecavir, to control viral replication. Maintaining viral suppression can slow the progression of liver fibrosis and substantially lower the risk of liver cancer.

Decentralised testing and treatment processes can therefore reduce administrative delays and allow therapy to begin sooner. However, patients receiving treatment still require consistent follow-up. Regular liver-function testing and viral-load monitoring help assess treatment adherence and determine whether the virus remains suppressed. For patients with cirrhosis, periodic abdominal ultrasound examinations and alpha-fetoprotein testing can assist in detecting early signs of malignant changes. Strong surveillance systems consequently support long-term survival while helping reduce transmission within communities.

Dual Clinical Imperative: Preventing Liver and Renal Toxicity

While efforts continue to control viral hepatitis, healthcare professionals must also protect patients from medication-related damage to vital organs. Chronic inflammation of the liver can increase overall physiological vulnerability and may make kidney regulation more sensitive to stress. When the interaction between the liver and kidneys becomes impaired, commonly used medicines can contribute to sudden or progressive kidney damage. Healthcare providers must therefore carefully balance treatment needs with responsible medication management.

The Central Drugs Standard Control Organisation has also issued an important warning concerning kidney toxicity. The national drug regulator has cautioned against inappropriate use of pain medicines, particularly non-steroidal anti-inflammatory drugs, as well as systemic antibiotics. Unsupervised self-medication and inappropriate prescribing can substantially increase the likelihood of chronic kidney disease. This is particularly relevant for patients with chronic liver conditions, where additional kidney injury can make medical management more complicated.

Medication-related kidney injury can commonly appear as acute interstitial nephritis or acute tubular necrosis. NSAIDs reduce prostaglandin production, potentially interfering with the kidneys’ ability to maintain adequate blood flow during low-volume states or existing cirrhosis. This can cause a rapid decline in the glomerular filtration rate and potentially lead to acute-on-chronic organ failure. Physicians should therefore review a patient’s baseline creatinine level, fluid status and liver function before prescribing analgesics or potentially nephrotoxic anti-infective medicines. During hospital-based analgesic treatment, healthcare teams should also monitor urine output.

CDSCO Regulatory Directives on NSAID and Antibiotic Use

To address increasing kidney-related health risks, the Directorate General of Health Services has drawn attention to existing legal requirements. A CDSCO circular dated September 21, 2026, reiterates statutory requirements under the Drugs and Cosmetics Act. Under these regulations, retail pharmacies are not permitted to provide prescription-only analgesics and antimicrobial medicines without a prescription from a registered medical practitioner.

Most non-steroidal anti-inflammatory drugs are classified under Schedule H of the Drugs Rules, 1945. Rule 97 requires manufacturers to display appropriate warning labels stating that these medicines cannot be sold at retail without a valid prescription. Likewise, many systemic antibiotics are included under Schedule H1 and carry specific statutory warnings against inappropriate use. These classifications are intended to address the risks associated with indiscriminate antibiotic use, including antimicrobial resistance, as well as kidney damage linked to uncontrolled analgesic consumption.

The regulatory directive also instructs healthcare professionals to prescribe these medicines only when there is a confirmed clinical need. Doctors are expected to determine suitable doses and restrict treatment to the shortest necessary duration. Community pharmacists, in particular, are required to stop dispensing these potent medicines over the counter for minor health complaints. State licensing authorities have additionally been directed to examine pharmacy records and systematically verify prescription documentation. Regulatory enforcement combined with professional adherence can help reduce preventable medication-related kidney damage across the country.

Actionable Recommendations for Primary and Specialist Care

Healthcare professionals have a vital responsibility in protecting public health while supporting national disease-control objectives. Healthcare providers should first identify people at increased risk of viral hepatitis, including pregnant women, individuals receiving haemodialysis and household contacts of infected people. When testing confirms an infection, doctors should promptly connect patients with centres operating under the National Viral Hepatitis Control Program. Healthcare teams should also promote completion of the recommended hepatitis B vaccination series among people of all age groups.

Doctors should also take particular care when choosing pain-relieving and antimicrobial medicines. Before prescribing analgesics, clinicians should assess existing health conditions such as hypertension, diabetes and borderline kidney impairment. For mild or moderate pain, appropriate doses of paracetamol that are safe for the liver or non-drug treatment options may be considered. This cautious strategy can reduce unnecessary exposure to nephrotoxic NSAIDs.

Antibiotic stewardship similarly requires healthcare professionals to rely on appropriate diagnostic evidence before starting antimicrobial treatment. Doctors should avoid prescribing antibiotics simply because patients request them for viral upper respiratory infections that are expected to resolve on their own. Healthcare institutions should also conduct routine reviews of prescribing patterns to identify inappropriate drug combinations. These measures can help protect vital organs, limit antimicrobial resistance and support India’s broader disease-elimination objectives.