Hepatitis C in Egypt
In Egypt, the country with the highest prevalence of hepatitis C in the world, the virus affects an estimated 6.3% of the population. Since 2014, Egypt has made great leaps in combatting hepatitis C. With support from the World Bank, the Transforming Egypt’s Healthcare System Project has worked to improve the quality of healthcare offered across medical facilities, as well as tested and treated patients infected with hepatitis C. Between 2018 and 2019, almost 50 million citizens were tested and 2 million patients received free treatment.

What is Hepatitis C?

Hepatitis C, or HCV, is a viral infection transmitted through unscreened blood transfusions and the use of contaminated or unsterilized needles, as well as instruments used for tattooing or body piercing. While it can remain asymptomatic — in most cases, if untreated, hepatitis C can eventually cause chronic infections, liver inflammation (or failure) and death. Hepatitis C is a serious public health issue, which causes financial and social stress for patients and Egypt as a whole.

The hepatitis C epidemic began in Egypt during the 1950s–1980s, with the use of poorly sterilized needles in the treatment of schistosomiasis, a disease caused by parasitic worms. The anti-schistosomiasis treatment campaign terminated in the 1980s. However, HCV incidence rates remained high, despite regular screening of blood at blood banks and attempts to improve public health standards.

Mass Screening & Awareness Programs

In 2014, the Egyptian Ministry of Health, with support from the WHO, proposed with a program to educate, test and treat patients infected with hepatitis C, particularly in rural areas where the condition was more prevalent. Most of the treated citizens already had a positive diagnosis for the virus. Later, as the number of patients began to stagnate and dwindle. Efforts then shifted to testing and treating those who had possible infections but remained asymptomatic.

In 2018, a national population-based screening program was launched to test 62 million adults and 15 million adolescents. Additionally, the free screening program also included tests for diabetes, obesity and blood pressure. The program, offered at screening centers and mobile units set up at community spaces such as mosques, youth centers and factories — also provides HCV treatments.

Low-Cost Drugs & Free Treatment

The Egyptian government successfully negotiated significant price reductions for direct-acting antiviral (DAA) drugs with the drug manufacturer. Egypt achieved a further reduction in prices by permitting local, generic competition. This reduced the price for one DAA drug from $28,000 to $23 (for a one-month supply) and a second drug from $21,000 to $3.30. This allowed the Egyptian government to combat the epidemic on a scale that would have otherwise been impossible.

Furthermore, the Egyptian government offered a 12-week treatment program and follow-up care, free of cost for citizens. Between 2014 and 2019, the Egyptian government offered free care to 88% of patients.

A Healthcare Model for the World

The Egyptian government, with support from the World Bank and in alignment with the WHO, has made continued efforts to tackle hepatitis C through mass programs that spread awareness among citizens. These same programs provide free, accessible testing, vaccination, infection control, treatment and follow-up. While Egypt is still working to rescue its population from this epidemic, the country offers a model of admirable success for the rest world.

Amy Olassa
Photo: Flickr

Healthcare in Egypt
In early 2020, the population of Egypt increased to more than 100 million. Overcrowding in urban spaces, with an estimated 95% of the population living on about 4% of the land, has aggravated pollution and traffic while placing a strain on resources, such as clean drinking water. The poverty rate was at 32.5% in 2019, and unemployment, especially among youths, has elevated the need for affordable, accessible and quality healthcare. In recent years, these concerns have led to the implementation of measures to reform Egypt’s underfunded public healthcare system. Here are seven facts about healthcare in Egypt and measures to reform the system.

7 Facts About Healthcare in Egypt

  1. In Egypt, the Ministry of Health and Population governs the healthcare system comprised of the government, public/parastatal and private healthcare sectors. In 2016, reports determined that there were 1.5 beds per 1,000 people This is low in comparison to the world average of 2.7 beds per 1,000 people.
  2. The public/parastatal sector consists of quasi-governmental organizations such as the Health Insurance Organization and the Curative Care Organization. Citizens can obtain insurance coverage via private insurers who have government support. However, many consider services that public healthcare facilities to be low in quality due to years of underfunding. The lack of medical equipment and qualified personnel in combination with low sanitation and compromised safety measures, especially in facilities located in rural areas, compel citizens to turn to private facilities.
  3. Private healthcare facilities consist of nonprofit organizations and for-profit hospitals, clinics and pharmacies. With increased privatization and better quality healthcare, these facilities account for the dominant portion of services that Egypt provides. People largely have to pay expenses out-of-pocket (60% of health spending, as recorded in 2007-2008) and accessible only to people who can afford care. The private healthcare sector is highly fragmented, with the fewest number of beds in comparison to government and public/parastatal facilities.
  4. In 2017, reports determined that the maternal mortality ratio was 37 per 100,000 live births. The ratio has decreased substantially since 2000 when records stated it was at 64 per 100,000 live births. In the past few years, the WHO, UNICEF and UNFPA have worked with the Ministry of Health and Population to improve the quality of obstetric and emergency care, access to family planning as well as midwifery and nursing care.
  5. In 2018, the Universal Health Insurance Law emerged to restructure the healthcare system by providing universal health coverage and making healthcare services affordable to all citizens. In June 2020, The World Bank announced $400 million in support of the implementation of the Universal Health Insurance System. The phased implementation of this law should be complete by 2032. It requires compulsory enrollment by all citizens residing in the country, with vulnerable groups receiving subsidization from the government. This law is also in alignment with the nation’s focus on preserving human capital through better prenatal and early childhood care.
  6. In Egypt, hepatitis C, an epidemic that has stretched across three decades, affected an estimated 6.3% of the population. In 2018, The Transforming Egypt’s Healthcare System Project emerged in alignment with the WHO’s Global Health Sector Strategy on Viral Hepatitis and with active support from The World Bank. The project accomplished mass-screening that tested more than 50 million residents and offered free treatment to more than 2 million patients.
  7. As of July 2020, Egypt has reported more than 4,000 deaths and over 85,000 cases of COVID-19. However, since testing is limited, the actual numbers could be higher. The pandemic has uncovered a lack of sufficient PPE supply and exposed a strained public healthcare system. In May, 2020, The World Bank provided $50 million in funding to Egypt’s COVID-19 Emergency Response Project.

Egypt still requires work to reform its healthcare system. However, the implementation of the Universal Health Insurance Law and continued support from international organizations, such as The World Bank, is helping make a change. These combined efforts are working to make quality healthcare accessible to all citizens of Egypt.

Amy Olassa
Photo: Wikimedia Commons