The Chinese government needs to improve access to hepatitis treatment if it wants to save 10 million lives by 2030, the World Health Organization said on World Hepatitis Day on July 28.

An estimated 100 million Chinese suffer from hepatitis B or C, chronic viral infections that require lifelong treatment at high medical cost. Without treatment, hepatitis can lead to cirrhosis or liver cancer, but the WHO believes that one out of every 13 Chinese who already suffers from chronic hepatitis and is in acute need of treatment is completely unaware of it.

Overall, only one out of 50 people in need of treatment actually receives it. The biggest hurdle, the WHO said, are the high costs of drugs and other treatments. Treatment for hepatitis B and related diseases can cost a patient almost half of their annual household income — far beyond their disposable income, the WHO said.

It’s a tremendous financial burden, said 40-year-old Chen Yuancai, who has suffered from hepatitis B for 10 years.

A month’s supply of pills for the drug he’s currently using, tenofovir, which is recommended by the WHO, costs 1,470 yuan (about $220) in China. Chen, who works at a tree nursery in Fuzhou, the capital of China’s eastern Fujian province, simply can’t afford the treatment.

So, like some other hepatitis patients who struggle to pay for their treatment, Chen has turned to India, from which a box of tenofovir can be shipped to patients in China for 450 yuan (around $67). “Why do we have a group of 28 million patients in need of treatment in China, but we have to go to India for medication? Why is there nobody to help us?” Chen said.

Getting his medicine from India comes with risk: The drugs could be counterfeit, or not transported under the right conditions. They could also be confiscated by Chinese customs, which has happened twice to Chen. When customs notified him that his drugs were being confiscated, he rushed to their offices to show his medical records — but to no avail. “I stood there and burst into tears. I felt so helpless,” he said.

Since last year, Chen has written over 20 letters to the local health department, the Fujian government, and the provincial governor to raise awareness and to ask that treatment be covered by insurance. On Wednesday, a day before World Hepatitis Day, patients with hepatitis B in eight provinces sent letters to 101 city governments that do not yet cover parts of the medical treatment under health insurance for chronic diseases.

“The challenge now is to make sure that hepatitis B treatment is fully included in health insurance schemes,” said Dr. Bernhard Schwartlander, China’s WHO representative.

Some progress has already been made, and a new policy has dropped prices for drugs. Tenofovir, for example, is 67 percent cheaper. That would make it possible to include the drugs under existing health insurance schemes in the future, Schwartlander told Sixth Tone.

Although the new price policy has been approved nationwide, implementation has been slow. Chen has been checking with local hospitals, but so far the prices haven’t dropped yet. “I’m still waiting,” he said.

(Header image: Chen Yuancai gestures as he holds a slogan reading ‘Chronic hepatitis B should be covered under health insurance for chronic diseases. Say no to discrimination, live a healthy life,’ as part of the Youyi Charity campaign, Fuzhou, Fujian province, July 27, 2016. Courtesy of Chen Yuancai)