Scaling up Hepatitis C diagnosis and treatment in Punjab Dr Gagandeep Singh Grover State Programme Officer, IDSP/HCV Punjab

Current Data of 25000 patients Patient flow – passive Mapping of areas being done

Scale up - Future Plan Strategy Prevention Diagnosis Treatment

Prevention of HCV in Punjab Injection safety Punjab is the first state selected by WHO for injection safety project TEG (Technical Expert Group) constituted in collaboration with WHO for injection safety Policy for shift to RUPs in Public and Private hospitals Waste management WHO Collaborating with Punjab for technical inputs in implementation of the program

Injection Safety in Punjab: Goals Adoption of safety-engineered syringes: e.g., RUP Develop a road map and State Implementation Plan (SIP) with timelines, for making injections safe in Punjab state of India Establish Model Injection Centers (MICs) in all district hospitals, medical colleges and nursing colleges of Punjab state.

Counselling of HCV patients All HCV patients to be counselled ICTC PSACS Contact tracing and high risk group identification

Collaboration with FIND Gene Xperts 4 places in State DH Bathinda DH Sangrur DH Tarn Taran MRHRU CHC Bhunga, Distt Hoshiarpur Viral Load Distt to be linked with these 4 Decentralized model Screening will be at SDH and DH level

Active Interventions Phase I: HIV +ve patients attending ICTC IDUs at OST centre IDUs at TIs under PSACS These HRGs will be screened with Rapid Tests CBC/LFT/RFT are already free Viral load with geneXpert Treatment by Govt. of Punjab

Active Interventions Patients on Haemodialysis Thallasaemic patients At GMCs and DHs Thallasaemic patients Jail Inmates Collaboration with Deptt. Of Prisons of Punjab for screening of high risk cases Viral Load/ Genotype with Dr Lal Path Lab Tt by Deptt. Of Health

Active Interventions Phase II All Health care workers will be covered under FAPHC + Free Annual Preventive Health Check up with HBV & HCV Pregnant females attending antenatal clinics

Challenges Scale up for active intervention requires Planning Financing HR Diagnostics Drugs Prevention Monitoring