By Yashwinder Singh – Community Representative, Steering Committee, National Viral Hepatitis Control Program (NVHCP), MPP’s Community Advisory Panel member. 

As a proud member of the LGBTQ+ community who has spent over two decades on the ground in HIV programmes and walking alongside communities hit hardest by the deadly but silent hepatitis C virus (HCV), this fight is deeply personal. I lost many friends to hepatitis C (commonly referred as Kala-Peellia in the local Punjabi dialect). Working to support the NVHCPis not about numbers, PowerPoint presentations, or policy issues discussed behind closed doors, it is about my friends, my chosen family, and the countless individuals across our villages and towns who have had to battle both this silent virus and crushing social stigma.

Acting as a community representative on the National Steering Committee of NVHCP has shown me both sides of the coin—the high-level policy processes in Delhi and the grassroot reality in states like Punjab & Haryana, where the burden of viral hepatitis (especially hep C) has always been high.

Thankfully, the scientific breakthroughs have transformed HCV into a curable reality. I still remember those days of interferon-based treatment. It felt less like a treatment and more like a punishment—prohibitively expensive, heavy on the body, and totally beyond the reach of marginalised communities.

Today, I would like to thank the scientific and global health community for the breakthroughs, affordable and quality generic manufacturing, the political will, and relentless, loud community voices and advocacy. We are rewriting the narrative.

India’s progress offers blueprint lessons for the global race toward the WHO’s 2030 elimination goals. But this journey has taught me one absolute truth: sirf dawai kaafi nahi hai,”medicines alone are not enough”. The people—especially those society pushes to the absolute fringes—must be at the very centre of the strategy.

From Interferon to Cure: A New Era on the Ground

For years, many within the drug user community and intersectional – MSM (Men who have Sex with Men) and Transgender (TG) communities – alongside other vulnerable groups, lived in the shadow of fear. Fear of the unknown, fear of discrimination, fear of testing and fear of the treatment itself.

The arrival of Direct-Acting Antivirals (DAAs) in the last decade changed the game entirely. Short, highly tolerable, and over 95 per cent effective, these pills brought genuine hope.

I remember the day – 26 July 2018 – when the Ministry of Health of India launched the NVHCP flagship programme. It marked a historic turning point, offering free screening, diagnosis and treatment through the public healthcare system. Mechanisms like voluntary licensing, supported by the Medicines Patent Pool (MPP), have been absolute gamechangers. They enabled domestic manufacturers to produce high-quality, life-saving drugs at a fraction of global costs, securing health equity not just for India, but for low- and middle-income countries (LMICs) across the globe. The scale and reach of Indian generic pharmaceutical capability complemented this monumental shift.

Photo: NVHCP Sensitization Workshop with MSM and TGW community members, Dec 2019, New Delhi)

My journey with the national programme took a pivotal turn in 2019, when I was fortunate to be part of the first batch of more than 35 community master trainers from the MSM-TG community officially trained by the NVHCP. That initiative was life changing; it recognised that if you want to reach the community, you must empower the community to lead. Subsequent steering committees were formed at state level, where community champions trained in 2019 were part of governance process in their respective states.

Why Community Voices – (Hamari Awaaz) – Truly Matter

When you belong to a community navigating multiple layers of systemic stigma – whether due to sexual orientation, gender identity, drug use or HIV status – trust is the only currency that matters. A government clinic banner can be intimidating, but a peer counsellor is a haven.

Throughout my journey over the last two decades working for community advocacy, I have witnessed community-led groups across India quietly doing the heaviest lifting: raising awareness in safe spaces, hand-holding peers through treatment adherence, addressing institutional stigma, and helping individuals navigate complex hospital pathways and much more. This is truly demonstrated by the success of HIV programmes: engaging the community makes the difference.

As the community voice on the National Steering Committee, I get the opportunity to bring community voices to policy discussions. I advocate for services that accommodate the lived realities of our people—whether that means addressing the deep-seated hesitation a gender expression-heavy TG individual feels when walking into a busy civil hospital, or pushing for decentralised, single-window care so a daily-wage earner doesn’t lose several days of work just to get a viral load test done. While working in the Punjab NVHCP program, this was further strengthened with innovative models proposed to the state, where services were planned directly at the communities’ doorsteps, engaging CBOs and existing HIV prevention programme Drop-in centres (DICs).

The Indian Model: What We Have Achieved

In a remarkably short span, India has demonstrated incredible scale:

  • Crushing Treatment Costs: Bringing down the price of DAAs through robust generic competition.
  • Free Care Pathways: Removing financial barriers by providing zero-cost diagnostics and medicines in public facilities.
  • Decentralisation: Shifting care from metropolitan centres to district-level delivery.
  • Community Ownership: Incrementally opening doors for peer-led outreach and training.

The Challenges on the Horizon

Despite real progress, significant challenges remain. Many people are still lost between initial screening and confirmatory testing due to long distances and fragmented systems. Linkage between HCV services, harm reduction programmes, and OAT (Opioid Agonist Treatment) centres is inconsistent across states. Stigma — in clinical settings and beyond — continues to deter care-seeking, particularly among marginalised groups. Access to salvage regimens for treatment failure cases within the public sector remains limited.

Scaling the Final Peak: The Role of Next-Gen Therapeutics

To bridge these gaps, adopting optimised tools is essential. Glecaprevir/Pibrentasvir (G/P) presents significant operational advantages: a shorter eight-week regimen for many treatment-naïve individuals, safety profiles suited for those with severe renal impairment, and a simplified delivery model. It is also better adapted to the main HBV genotype in my region.

By bringing generic versions of such advanced combinations into wider circulation through generic production licensing, we can streamline procurement, reduce treatment drop-out rates, and extend a lifeline to the most marginalised sub-populations who find long-term treatment adherence difficult.

The Way Forward

As we count down to 2030, our focus must sharpen on execution at the absolute last mile:

  1. Community-Led “Test and Treat” Models: Empowering community drop-in centres to screen and initiate basic care pathways.
  2. Point-of-Care Diagnostics: Deploying rapid, decentralised viral load testing to collapse the time between screening and cure.
  3. Deep Integration: Co-locating Hepatitis C care within existing Targeted Interventions, OAT centres, and community safe spaces.
  4. Equitable Access to Salvage Regimens: Ensuring no one is left behind due to a lack of secondary treatment options in the public sector. Bring generic G/P to market.
  5. Sustained Funding for Peer Networks: Investing heavily in the training and livelihoods of community educators who act as the primary bridge to care.

We, the affected communities, are not passive beneficiaries of charity; we are essential partners in a shared mission. When we are given a meaningful seat at the table, policies become practical, systems reach further, and elimination transitions from a bureaucratic target into a lived reality. India’s HCV story is living proof of what can be accomplished when science, political determination and community ownership converge. The fight continues, and if we stand together, a hepatitis-free future is well within our grasp.Science gave us the molecule, but it is the community that will deliver the millions. Let’s finish the job.