Two infections had comparable global death tolls in 2024: Tuberculosis (TB) killed 1.23 million, and Hepatitis B 1.1 million, while HIV-related illnesses killed 630,000. For Hepatitis B, the toll was 17% more than it was in 2015. In 2021, Hepatitis B consumed an estimated 21.5 million disability-adjusted life-years (DALYs). Nearly 30-35 million in India suffer from this infection and about 5-10 million may eventually die due to cirrhosis and liver cancer. Yet public recognition, political attention, and funding are strikingly unequal, with Hepatitis B receiving very low quanta of each. No wonder, the world, including India will miss the 2030 WHO targets — instead of the 90% targeted, diagnosing merely 3-15%, and the 80% targeted, treating just 5% of infected. Less than a million are receiving treatment despite a large National Viral Hepatitis Control Programme (NVHCP) since 2018.

The problem is the medical profession itself. Unlike HIV and Hepatitis C (another liver virus causing cirrhosis and cancer) where every patient receives treatment, for Hepatitis B, medical algorithms demand high viral load, abnormal liver enzymes, liver scarring or fibrosis for getting treatment. Patients who fail to qualify must undergo repeated blood tests, viral-DNA measurements, fibrosis assessments,........

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