India still struggles with a high burden of Hepatitis B and C. What are the gaps in screening, prevention, and vaccination that must be addressed?
Ignorance remains one of the biggest challenges, with the government failing to create public awareness about the severity and risks of the disease. Unlike successful campaigns for polio, the government has hardly focused on hepatitis. For instance, roadside barbers, who are at high risk of transmission, are completely unaware of Hepatitis B and C. Due to lack of awareness, many people do not understand the importance of vaccination, which affects both children and adults. While there has been progress in Hepatitis B vaccination among children, a significant portion of the population, especially adults, remains at risk.
I would also say Hepatitis C is emerging as a big public health problem. In Punjab, it is more severe because of drugs. But you will be surprised to know that Hepatitis C cases are also increasing in Odisha, particularly among the youth. Widespread education, particularly for healthcare workers and high-risk groups, and better public health infrastructure can ensure that both preventive measures and treatment for hepatitis are easily accessible to all.
Liver disease cases are rising alarmingly across the country. You have done pioneering work in non-alcoholic fatty liver disease (NAFLD), which is emerging as a silent epidemic. What do you see as the biggest drivers of the rise?
Lifestyle and food. With progress and modernity, our food patterns and living habits have changed. We are eating much more than we did as children. Again, the type of food we are having is obesogenic. Correspondingly, our physical activity level has gone down to the minimum, thanks to TV and mobile screens.
Now, this can be corrected if people are aware of what is good and bad for them. We conducted a study on patients with fatty liver disease and normal people and were surprised to find that at least two-thirds of those who were overweight or obese thought their weight was normal. This is very much linked to our culture. People don’t give much importance to their weight. In many cases, even doctors and health professionals are not aware of the problem.
However, there is a simple formula to overcome fatty liver disease. In most cases, one does not need any medication. The most potent cure is food and exercise. Exercise, walking, and a physically active lifestyle with a healthy diet will automatically bring down weight and resolve NAFLD.
We are also working on a formula for weight and its correlation with NAFLD for Indians. We are going to publish it soon. Your waist circumference should be half of your height. If it exceeds that, you are definitely at risk of having fatty liver. You have to keep it below that level. All the tests currently being done are also not validated in Indians. The fatty liver we have is different from that of the West. I have been saying this from the beginning.
Alcohol and smoking are other major causes of fatty liver. The biggest killer in liver disease today is not Hepatitis B; it is alcohol. All the wards are chock-a-block with alcoholic liver disease patients.
