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The Fight Against Liver Epidemics in Egypt: Then and Now

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The Fight Against Liver Epidemics in Egypt: Then and Now

Even though the most effective solution to liver failure is transplantation, a handful of social, religious, and legislative restrictions in Egypt have made transplants an often unrealistic solution for patients.

Egypt has the second highest incidence rate of liver failure in the world. For liver disease patients, whose conditions are not yet critical, the alternative to transplantation is a methodical treatment plan that combats the disease at the source.

That source has shifted over the years; today, viral hepatitis C is one of the leading causes of liver failure in the country. Nevertheless, Egypt has emerged at the fore of the global fight against the disease.

In 2014, Egypt’s Ministry of Health and Population disclosed its plan of action for the prevention, care and treatment of hepatitis C, a disease that is among the top 10 causes of death in Egypt, as reported by the Centers for Disease Control and Prevention in 2010.

In recent years, the Egyptian Ministry of Health and Population has implemented measures to eliminate hepatitis C, including strengthening detection methods of the disease, controlling transmission and treating affected patients.

Egypt’s first breakthrough was when Gilead Sciences, a US based biopharmaceutical company, developed a cure approved by the US Food and Drug Administration in 2013 called Sovaldi. Egypt, then negotiated a deal to reduce the price of the treatment in the country.

Treatments became even more accessible at the beginning of 2015 when Egyptian companies started manufacturing medicines using the same active ingredient present in Sovaldi.

“Gratisovir [locally manufactured treatment for viral hepatitis] has the same effect as Sovaldi and it has a very high success rate of 97 percent. It has received very positive feedback from the majority of its users, but it is not taken alone, the pills are taken by the patient simultaneously with a medicine called Ribavirin,” stated Hanan Alsherif, independent pharmacist.

In May 2016, Egyptian efforts to combat hepatitis C expanded even further to the global level. Prime Pharma, an Egyptian pharmaceutical company, in cooperation with EgyptAir, inaugurated the medical tourism program called Tour n’ Cure.

The program aims to energize Egypt’s tourism sector while sharing Egypt’s low-cost hepatitis C treatment with the world.

In the early 1900’s, the culprit was bilharzia, a parasitic disease that caused a liver-related epidemic. In 1972, then-minister of health Mahmoud Mahfouz released Egypt’s first official report on national health policy which highlighted the country’s need for a bilharzia control program. According to the report, Egypt spent over 8 percent of the per capita public health expenditure on controlling the disease, a figure that was later reduced to around 5 percent.

After over six decades of Bilharzia control efforts, a World Bank report revealed that the incidence rate was reduced by 20 percent in middle Egypt between the late 1970’s and 1980’s. It also dropped by about 7 percent in upper Egypt between 1980 and 1988.

“After the management of Bilharzia, there are rarely any cases now, and I think after the development of the treatment of hepatitis, after 10 or 20 years, cases of cirrhosis will end and we now have great success of treatment of hepatitis and there will be no need in liver transplant,” said Bahaa Elwakil, Consultant of Surgery at the National Institute for Research on endemic diseases and liver.

Watch the below video on organ donations in Egypt that was produced together with this article.

 

Credits:
This article is produced by a multimedia journalism student, Merna Sakr, at the American University in Cairo (AUC) and supervised by professor Kim Fox in Fall 2017. 
This video is produced by a multimedia journalism student,Noura Shibl, at the American University in Cairo (AUC) and supervised by professor Kim Fox in Fall 2017.

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