Departing from Shanghai on June 26 and arriving in Beijing at around 2 pm on September 13, the 1,552-kilometer journey took hepatitis B carrier Lei Chuang 80 days on foot.
Lei Chuang’s hiking journey was aimed at one straightforward purpose: to submit to the National Health and Family Planning Commission a “Proposal Regarding the Inclusion of<国家基本药物目录>Antiviral Drugs for Hepatitis B on the National Reimbursement Drug List,” in hopes of lowering the cost of hepatitis B medication and easing the financial burden on the 20 million patients with chronic hepatitis B.
That afternoon, Lei Chuang arrived at the National Health and Family Planning Commission to deliver the proposal. Officials warmly received him and his father, stating that the letter would be forwarded to relevant leaders for review.
“Hepatitis B Advocate” Lei Chuang Hikes to Beijing to Deliver Proposal Letter
Hiking to Beijing to Deliver Letter — a Full 80 Days
Since departing on foot from Shanghai on June 26, his journey lasted a full 80 days.
At around 2 pm on September 13, Lei Chuang finally arrived at No. 154 Gulou West Street, Beijing — the Reception Office for Visits by the Public under the National Health and Family Planning Commission.
Since departing on foot from Shanghai on June 26, his journey lasted a full 80 days.
Hepatitis B advocate Lei Chuang named this trek “Beneficial Journey to Beijing.” Braving the summer heat to promote public welfare, he had one goal: to deliver to the National Health and Family Planning Commission a “Proposal Regarding the Inclusion of Antiviral Drugs for Hepatitis B on the National Reimbursement Drug List”<国家基本药物目录>(hereinafter referred to as the “Proposal Letter”), in hopes of reducing the cost of hepatitis B medication and easing the financial burden on the 20 million patients with chronic hepatitis B.
The head of the Letters and Visits Division One of the NHFPC was waiting at the entrance of the reception office and welcomed Lei Chuang and his father inside.
“During my hike, I sent letters to the NHFPC from every place I passed through to update them on my progress,” said Lei Chuang, who believes that rational and timely communication may have been why officials chose to receive him personally.
From Shanghai to Beijing, Lei stamped the Proposal Letter with postmarks from every location he passed and collected signatures of supporters along the way. He presented the postmarked, signed Proposal Letter to the division head.
“Although the Proposal Letter is just a few pages and very light, it is closely related to the vital interests of tens of millions of people with hepatitis B,” Lei explained his purpose and process during the “Beneficial Journey,” emphasizing the weight the letter carried in his heart. He hoped that delivering it to government departments by hiking to Beijing would draw attention from the relevant authorities.
The division head responded by saying that the original letter would be forwarded to relevant leaders for review.
As for when Lei could expect a response, the division head noted that because the proposal involved national policy — unlike individual petitions due to personal grievances — there was no specific timeline for a reply, but they would contact him as soon as there was any result. The official then invited Lei and his father to take a photo together.
Rational Expression of Demands Achieves “Government-Citizen Interaction”
Attempting to express demands in a nonviolent, gentle, and rational manner to achieve “government-citizen interaction, consensus-building, and problem-solving”
In 2007, after a relative faced hepatitis B discrimination while job hunting, Lei Chuang began paying attention to the issue and has since spent six years advocating and campaigning.
During this time, he wrote to 1,983 university presidents and 524 academicians calling for an end to hepatitis B discrimination in education; in 2009, he successfully obtained China’s first health certificate for food industry work as a hepatitis B carrier; in 2010, he took a year off school and, along with friends, organized “invite people to dine” events as hepatitis B carriers to raise awareness about the disease...
In April of this year, Lei Chuang graduated with a master’s degree in chemical engineering from Shanghai Jiao Tong University. Unlike his classmates, he didn’t rush to find a job but instead embarked on a special graduation trip — hiking from Shanghai to Beijing to speak out for the hepatitis B community.
According to the “Beneficial Journey to Beijing, Walking for Change” implementation plan provided by Lei Chuang, on June 26, he set off from Shanghai Jiao Tong University and headed north along the Beijing-Hangzhou Grand Canal, covering the full 1,552 kilometers without using any transportation. Crossing the Yangtze and Yellow Rivers and passing through Jiangsu, Shandong, Hebei, and Tianjin, he is expected to arrive in Beijing on September 16.
Traveling alone, Lei Chuang also brought along a green plant from Shanghai as his companion: “Green symbolizes hope — hoping the National Health and Family Planning Commission will adopt the proposal.”
But he wasn’t alone on this journey. Due to his “Beneficial Journey to Beijing,” over 40 volunteers joined him at various points to accompany him, provide water, or donate money. One volunteer, Peng Shuo, a college student from Yichang University in Hubei, accompanied him for a month.
Lei Chuang turned “asking for water along the way” into an excellent way to spread the concept of public welfare. As the hike took place during peak summer heat, Lei often had to ask residents or shops for water to quench his thirst. With his straw hat, “Beneficial Journey to Beijing” sign, and luggage in tow, he attracted curious glances. Satisfying that curiosity became his best opportunity to explain the purpose and meaning of his trip.
Lei Chuang also used his Weibo account to publish “Lei Chuang’s Donation Usage,” providing real-time updates on how every donation was spent.
Six days before the end of the journey, Lei Chuang’s father traveled by train from Zhong County, Chongqing, to Tianjin to accompany his son for the final leg from Tianjin to Beijing.
Just before this article went to press, Lei Chuang told a reporter from the New Legal System Daily via Weibo private message that "Yi Xing to Beijing" aims to try expressing demands in a non-violent, gentle, and rational way, achieving "interaction between officials and the public to reach consensus and solve problems."
Hepatitis B treatment drugs: wide usage and high costs
There are over 20 million people who need medication for chronic hepatitis B. The high cost of the drugs and long-term use represent an undeniable heavy financial burden on chronic hepatitis B patients.
Lei Chuang explained that the “Guidelines for Prevention and Treatment of Chronic Hepatitis B (2010 Edition)” indicate that China has a population of over 96 million people who are long-term carriers of the hepatitis B virus, among whom more than 20 million require medication.
“The monthly cost of medication is about 1,000 yuan, and it needs to be taken continuously for several years without interruption,” Lei Chuang said. He expressed regret that although the group of people requiring antiviral treatment for hepatitis B is large, the cost of treatment is high, and the duration of medication is long, hepatitis B antiviral drugs have not been included in the “National Essential Medicines List” (hereinafter referred to as the “List”).
The List is the basis for medical institutions to equip and use medicines, including parts for primary healthcare institutions and other medical institutions. The medicines on the essential medicines list meet basic healthcare needs, have suitable dosage forms, reasonable prices, can ensure supply, and are fairly accessible to the public.
It is reported that chronic hepatitis B patients can undergo antiviral treatment using nucleoside (acid) analogs (oral) and interferon (injection) to maximally and durably suppress hepatitis B viral replication, reduce hepatocyte inflammatory necrosis and liver fibrosis, and delay or reduce the occurrence of liver decompensation, cirrhosis, hepatocellular carcinoma, and their complications. In addition, interferon is also an effective drug for chronic hepatitis C.
“It’s worth noting that there are 38 million chronic hepatitis C infections in China,” Lei Chuang specifically mentioned in his “Proposal Letter.”
However, both nucleoside (acid) analogs and interferon medications have the characteristic of requiring long-term use—the former must be taken daily for no less than two years, ordinary alpha-interferon is administered subcutaneously three times a week or every other day, usually for a course of six months, while long-acting interferon IFNα-2a or 2b requires weekly injections for a course of one year.
“The price of medicine that patients get from medical institutions is usually the maximum retail price or close to it,” Lei Chuang gave an example: according to the “Hunan Medicine Price Disclosure” website, taking Lamivudine costs patients about 400 yuan per month. Each dose of long-acting interferon is around 1,000 yuan, and patients pay about 4,000 yuan each month. Ordinary interferon (5 million IU per vial) costs about 60 yuan, and patients need to inject it three times a week or every other day.
High drug prices and long-term medication undoubtedly impose a heavy economic burden on chronic hepatitis B patients.
In addition, Lei Chuang pointed out that although chronic hepatitis B carriers do not require treatment, if they experience abnormal liver function (persistent or recurrent elevation of transaminases), or liver histological tests show signs of hepatitis, chronic hepatitis B carriers may become chronic hepatitis B patients. Without medication control, their condition may worsen further.
The goal of Lei Chuang’s 80-day walk “Yi Xing to Beijing” is clear: to recommend the immediate inclusion of drugs used for hepatitis B antiviral treatment—nucleoside (acid) analogs and interferon—in the National Essential Medicines List.
Lei Chuang said that currently, there are too many links in domestic drug circulation, resulting in inflated prices. According to relevant regulations, if hepatitis B drugs are included in the List, they will undergo unified bidding and cannot be sold at a markup, which would lead to lower drug prices and ease the financial burden on hepatitis B patients.
Calling for the inclusion of hepatitis B antiviral drugs in the National Essential Medicines List
Including hepatitis B antiviral drugs in the National Essential Medicines List is in line with the principles of the national essential medicines system of “meeting basic healthcare needs” and “equitable access.”
During this year’s National “Two Sessions,” Xie Zilong, a deputy to the National People’s Congress and chairman of Lao Bai Xing Pharmacy Chain Co., Ltd., submitted a proposal titled “On Including Hepatitis B Antiviral Drugs in...”<国家基本药物目录>In the proposal, he said that excessive links in drug circulation and inflated prices have been hot social issues in recent years, and antiviral drugs for chronic hepatitis are no exception. He suggested that when formulating the next version of the List, the country should include drugs used for hepatitis B antiviral treatment—such as nucleoside (acid) analogs and interferon—into the National Essential Medicines List. Meanwhile, NPC member Yao Aixing also submitted a proposal titled “On Including Hepatitis B Antiviral Drugs in...”<国家基本药物目录>Proposal of "
In fact, similar calls have been made for a long time. These proposals are all based on the “Notice on Issuing...” jointly issued by the Ministry of Health and multiple central departments (Wei Yao Zheng Fa [2009] No. 78) (hereinafter referred to as the “Notice”). The Notice clearly states that all primary medical and health institutions run by the government must be fully equipped and use essential medicines, and all other types of medical institutions must also use essential medicines as required.<关于建立国家基本药物制度的实施意见>Notice" (Health and Pharmaceutical Policy Development [2009] No. 78) (hereinafter referred to as the "Notice"). The "Notice" specifies that all primary-level medical and health institutions run by the government must be fully equipped with and use essential medicines, and that all other types of medical institutions must also use essential medicines as required.
“The essential medicines equipped and used by primary medical and health institutions run by the government are sold at zero markup, meaning that medical institutions sell the drugs at the actual purchase price without adding a markup,” Lei Chuang explained. If the suggestion is approved, according to the Notice, hepatitis B patients will be able to receive treatment at various levels of medical institutions nearby. Besides making treatment more convenient, this will also help reduce the price of hepatitis B drugs.
Currently, commonly used drugs for treating conditions such as hypertension and diabetes have been included in the basic list. For AIDS, the state has even introduced a “Four Frees and One Care” policy, providing free antiviral treatment for AIDS patients. “China has nearly 100 million chronic hepatitis B carriers and 20 million hepatitis B patients, yet not a single hepatitis B antiviral drug is included in the List,” Lei Chuang said. Including hepatitis B antiviral drugs in the National Essential Medicines List is in line with the principles of the national essential medicines system of “meeting basic healthcare needs” and “equitable access.”
Along the way, Lei Chuang has received countless expressions of support, but also skepticism about his act of walking for a cause: “One person’s strength is too small—even if he succeeds in reaching Beijing, it may not bring about change.”
Lei Chuang responded that although one “Yi Xing to Beijing” journey may not bring change, it is at least a step on the path toward change.