Traditional methods and herbs in the treatment of liver diseases
Plus gepatitizatsiya whole country
Diseases of the liver and gall bladder
Cirrhosis of the liver
Andrei Kapustin, "The Mirror of the week. Ukraine »№ 25
Exactly one year ago, the World Health Organization celebrated its second International Hepatitis Day. In Ukraine, where such an action should be carried out, as they say, three times a day, this event did not attract special attention of the authorities - not a single real step, despite the extreme importance of the problem, was made over the past year. Although the starting price of the issue seems to be ridiculous - about 300 million hryvnia. Funny - and against the background of a billion, which the deputies easily gave for the purchase of video cameras for the elections. And compared with 175 million, recently additionally allocated to the prosecutor's office. We will not say anything about how much budget money was thrown into the furnace of Euro 2012, as well as about “mezhyhirya”, helipads, “Boyko's towers” and tender-free cuts. Although viral hepatitis C (HCV) poses such a threat to Ukraine that all the current fears associated, say, with HIV or tuberculosis, may recede into the background. Including because these diseases quickly show their face. What can not be said about hepatitis C, which doctors call the "affectionate killer."
"Tenderness" of HCV lies in the fact that, being in the human body, it can destroy the liver for years, or even decades, without announcing itself with painful symptoms. Since the HCV virus is transmitted mainly through blood, absolutely all categories of the population are held hostage by the “affectionate killer”. Both social and age-related.
The danger lurks not only at the tip of a common drug addict's needle, but also in the dentist's office, in the tattoo parlor and in the manicure room, at the piercing master and in the acupuncture center - wherever a fatal virus can enter the bloodstream with a dirty instrument. Indeed, even the Ministry of Health admits that among medical workers the rate of hepatitis C patients reaches 40-60 percent. By the way, not only those who are on a needle, but also cocaine lovers - those who use a common tube to draw the drug through their nose, have a real chance of contracting HCV. It is enough for the patient to lightly hook the nasal mucosa with the tube so that the next lover of the "track" will receive the HCV pathogen along with the high. By the way, the fact that a drug addict jumped off the needle three to five years ago does not mean that he falls out of the risk group associated with HCV. How not to be surprised at unexpected cirrhosis or liver cancer for those who, in the late 90s, got a cool tattoo in the army or, say, in the zone. According to world statistics, 78 percent of all liver cancer cases are provoked by hepatitis B and C.
But the biggest threat of mass infection lurks in hospitals. And in all - from the murdered provincial to the most respectable. And those who need any procedures related to blood transfusion are automatically connected to the game of "Russian roulette". The insidiousness of the "affectionate killer" lies in the fact that after it enters the human body, it is almost impossible to detect it for another three months. Those. and any citizen who decides to become a donor, and the doctors who test his blood, simply do not know that they are dealing with a carrier of the virus.
It can be argued that the HCV problem exists in other countries as well. (On the planet, about 180 million people are sick with viral hepatitis C.) That, they say, in other countries, they take blood from donors in the same way and produce drugs from it. Correctly. But, unlike Ukraine, in those countries where problems of this kind are considered much more serious, blood is tested before being sent to hospitals using a diagnostic method such as, say, polymerase chain reaction - PCR. Today, PCR diagnostics is the most accurate and most sensitive method for diagnosing infectious diseases. In the USA, for example, such testing of blood products has been mandatory for more than one year. Which, by the way, is directly related to the absence of an increase in the incidence of HCV.
In Ukraine, PCR diagnostics is also used. But not everywhere. And not for everyone. And even more so not to check all donor drugs. Firstly, because there are few PCR laboratories, and secondly, because it is expensive. Moreover, they must pay in both private and public laboratories. For the state does not allocate money for the purchase of reagents. So the difference is only in price - from 500 to 1300 hryvnia.
Although the final answer - whether a person had hepatitis C or not, can not be given by express diagnostics (blood from a finger), but by PCR diagnostics.
Today, according to official estimates, there are 120 thousand carriers and 19 thousand HIV / AIDS patients in Ukraine. According to independent experts, this figure can be at least doubled. According to official estimates, there are about 460 thousand patients with tuberculosis. (Independent experts believe that it should be about a million people.) Which, according to NSDC Secretary Andrei Klyuev, poses a threat to the country's national security. But regardless of the discrepancy between the figures, Ukraine is the European "leader" in both diseases. But in situations with both HIV and tuberculosis, at least there are proven diagnostic methods (for example, fluorography) and approved treatment protocols. As for hepatitis C, there is practically nothing to compare. Official statistics have been kept in Ukraine only since 2009. There is no reliable data. And they have nowhere to come from. Because HCV is not only “affectionate”, but also difficult to identify the killer. There are only a vague 1,7 patients per 100 population. Although according to the WHO, the more realistic figure is 13 patients per 100 thousand of the population. Despite the fact that in Europe (with strict monitoring) we are talking about 4-5 patients for the same 100 thousand. Obviously, we are also among the European "leaders" on the HCV. For, according to WHO estimates, about 1130000 people are infected with the hepatitis C virus in Ukraine, i.e. about 3 percent of the population. According to estimates by independent experts, we can talk about numbers from 2,6 to 3,5 million people. Those. 6 to 9 percent. Mostly young, productive population of the country.
For example, experts from the All-Ukrainian public organization "Stop Hepatitis", which cooperates with the WHO and international anti-hepatitis organizations, came to such conclusions. Created by those who know what an "affectionate killer" is firsthand. Having received an international grant, they conducted an official survey of almost 9 thousand people aged 19 to 40 in three regions of Ukraine. They checked people far from traditional risk groups: students, railway workers, firefighters. The result is 5,74 percent. On a national scale, this is about 2,5 million patients.
At the same time, WHO experts believe that out of 1,13 million Ukrainian patients, 400 thousand people need urgent treatment. If the calculations of independent experts are correct, then this figure must be multiplied by two - i.e. 800 thousand people need treatment, which, unlike those with HIV or tuberculosis, the state does not provide them.
Depending on the type of virus (there are 6 main types and more than 40 subspecies) and the "age" of the disease, the course of treatment can last from 48 to 72 weeks. In addition to starting diagnostics, which can cost 1200-1300 hryvnias, you need to pass a bunch of tests for compatibility with drugs. That will cost another 2-3 thousand. The treatment itself costs an average of 9,5 to 11,5 thousand hryvnia per month. Plus accompanying therapy, which starts from the second month of treatment and varies in the range from 800 to 10 thousand hryvnia. Again, a month. So the minimum rate will cost about 220 thousand hryvnia.
It is not surprising that no more than XNUMX people are treated at full price in Ukraine.
Therefore, there is a very specific question for the state: what should the rest of 398 and a half thousand citizens do who do not have such money for treatment? The answer, alas, is predictable: “Due to the extremely limited financing of the centralized procurement of medicines for the treatment of the above category of patients (viral hepatitis. - AK), The Ministry of Health of Ukraine is not able to provide all the medical and preventive institutions of the health care system of Ukraine with the necessary medicines. " This is an excerpt from the official letter of the Ministry of Health (No. 2001/5/10/2784 of 14.11.11/17.10.2011/49662), which is a response to the control order of the Cabinet of Ministers (No. 1/1 / 11-2012 of 304/XNUMX/XNUMX) on consideration of the appeal of the All-Union Public Organization "Stop Hepatitis" , which required to allocate XNUMX million hryvnia to the XNUMX budget for the purchase of medicines for the treatment of viral hepatitis.
It seems that there is no need to remind once again about the lawlessness with the procurement of medicines, as well as the tender games in this field. So let's get back to specifics.
It is clear that such an impressive amount needed to treat patients could be attributed to the greed of the international pharmaceutical mafia. And along with those who serve this mafia in Ukraine. Examples are endless. If not for a few "but". On March 9, 2011, the Cabinet of Ministers, by its order No. 206-r, approved the Concept of the state targeted social program for the prevention, diagnosis and treatment of viral hepatitis for the period up to 2016. Where he actually admitted the existence of a disaster.
“Ukraine is close to the powers from the middle level of the widening of the viral hepatitis C (it is confirmed that there are about 3 large numbers of people, about 1170000 people). However, according to the results of vibrational monitoring of the group, the indicator of infection with hepatitis C virus in the middle of them (medical doctors, ailments on oncology and nephrological illness, but require the middle of the disease, VIL-40) ...
... Nizky rіven poіnformovanostі population about nebezpeku infected vіrusnimi hepatitis B i C neviznachenіst factuality rіvnya zahvoryuvanostі, zastarіlі techniques dіagnostuvannya, a temple vartіst lіkuvannya osіb scho strazhdayut on zaznachenі zahvoryuvannya, will only be sold to postіynogo pіdvischennya rіvnya zahvoryuvanostі on vіrusnі hepatitis B i C is the smertnostі od Tsikh get sick ".
The Ministry of Health, together with the interested central authorities, within three months was obliged to develop and submit to the Cabinet of Ministers a draft State targeted social program for the prevention, diagnosis and treatment of viral hepatitis until 2016. But also 506 days later, i.e. for the next International Day Against Viral Hepatitis, the program was not submitted. But the provisions of the concept were included in the state program "Health of the nation 2020: Ukrainian dimension". The only thing left for the Cabinet of Ministers is to issue a corresponding order stating that until the program itself is adopted, the HCV pathogen must suspend any harmful activity in the bodies of sick people.
Because the chances of adopting this anti-hepatitis program in the foreseeable future are few - after all, even the pompous "Health of the Nation: Ukrainian Dimension" has not yet been accepted.
De facto, everyone seems to recognize the problem. But de jure it doesn't seem to exist. And since there is no problem, then there is no funding. And hundreds of thousands of patients remain illegal - that is, without the right to state aid. So you shouldn't be particularly surprised when on anti-hepatitis forums the ubiquitous healers offer desperate patients recipes for healing with holy water and miraculous icons and relics ...
The state is in no hurry to register all patients with hepatitis C. After all, in this case, they will have grounds to demand immediate treatment and high-quality diagnostics from the state. At the same time, officials cannot help but have a question about who will import these drugs. But 220 thousand hryvnia per year is the cost of a de facto treatment course. Those. without wrapping, kickbacks and cuts. And, as you know, for officials, their absence immediately makes any question hopeless.
It's no secret that WHO is concerned that Ukraine does not turn into "European Egypt", where about 22 percent of the population is affected by hepatitis C. (Pyramid lovers, be careful!) And I am ready to assist in negotiations with pharmaceutical companies about discounts. But they agree to negotiate discounts on sales of significant quantities. And for this it is necessary to officially admit that about three percent of the population is really sick in Ukraine. And - oh, horror! - notify the head of state.
Can you imagine that daredevil who will come to the president with the words: “We have a problem with the“ deceased ”. It turned out that we are leading in Europe not only in AIDS and tuberculosis, but also in hepatitis C, which affects more than three percent of our population. Their treatment requires 88 billion hryvnia "...
And it is clear that the head of state will have to tell that HCV is a disease of young people, the most active part of the population. That if measures are not taken, by 2015 very many of them will be disabled. This, in turn, will cause not only a tangible reduction in the number of taxpayers, but also a sharp (up to 30 billion hryvnia per year) increase in pension costs. That the increase in the number of young people with disabilities is also the emergence of a new, very powerful electoral group, which has felt the real "care" of the state for its citizens, and the real "loss of life". Not to mention the fact that this group will also need to add family members, who will bear the burden of supporting their loved ones, since with the current disability pensions they simply will not survive.
One can only guess what the president will answer to the daredevil. Although it is necessary to inform the president. Maybe he will convene some particularly important operational meeting. Or even fire someone. Indeed, in the current system of power, this still works. Moreover, the tight contraction of the bureaucratic age will only aggravate the situation.
How is it, at Grebenshchikov's: "There are dancing on the deck, in the hold there is a five by five hole ..."?
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