During the commemoration of World Hepatitis Day, Dr. Khaled Abdel-Ghaffar, the minister of health and population, announced that Egypt has taken a significant step towards becoming a hepatitis C-free country.
The ministry has submitted a file to the World Health Organization, which is currently under examination at the regional office.
This momentous milestone signifies the successful campaign against hepatitis C in Egypt, made possible by the 100 Million Healthy Lives initiative led by the president, aiming to combat hepatitis C and proactively identify noncommunicable diseases, he added.
During a televised address on World Hepatitis Day, the minister highlighted the comprehensive attention dedicated to liver patients, unveiling the outcomes of the liver cancer early detection initiative, which received the invaluable support of Bayer International under the auspices of the 100 Million Healthy Lives campaign.
The liver cancer early detection initiative, which was launched in September 2019, offers periodic screenings, including ultrasound examinations and tumour marker tests, every four months, completely free of charge.
This initiative has established 75 examination centres and integrated them with 93 advanced diagnostic facilities and 47 state-of-the-art treatment centres dedicated to the management of malignant tumours, all available at no cost and bolstered by a multidisciplinary approach. So far, it has included nearly 116,000 patients from high-risk demographic groups.
He elaborated on the imperative need for collaborative efforts between governmental and non-governmental entities to ensure comprehensive care for patients. The Ministry of Health and Population, renowned for its commitment to progress, has established a remarkable track record in fostering and promoting such collaborations with all stakeholders within the medical realm.
Dr. Abdel-Ghaffar acknowledged that Egypt has endured the burdens of the medical, social, and economic impact resulting from the widespread prevalence of the hepatitis C virus for decades. However, Egypt has triumphantly confronted this challenge with unparalleled success.
Through unwavering determination and resilience, the country has remarkably transformed its classification from being the nation with the highest prevalence rates worldwide to becoming the frontrunner in attaining certification from the World Health Organization for the elimination of hepatitis C.
This milestone is the culmination of relentless efforts undertaken by the state since the 21st century. It is a testament to the initiative of the president of the republic to eradicate hepatitis, which has facilitated the screening of over 63 million citizens within seven months only.
This momentous achievement was hailed by the director-general of the World Health Organization as the most extensive and impactful health survey in human history, in terms of both its high quality, meticulous execution, and remarkable speed.
He stressed that this day signifies a milestone in establishing a sustainable model for delivering exemplary services to patients affected by hepatitis viruses, aligning with the forefront of scientific advancements.
It is a moment of great pride as Egypt’s triumph in achieving fairness and equality in access to top-tier healthcare services and global treatments is witnessed.
Moreover, the development and enhancement of national capabilities and their continuous access to the highest standards are ongoing endeavours.
Egyptian experts, in collaboration with partners from leading universities and centres specialized in liver and liver cancer treatment worldwide, have been diligently working together to construct a comprehensive and standardized diagnostic and treatment system. This collective effort aims to ensure seamless integration and deliver optimal care to patients.
During the World Health Organization's commemoration of World Hepatitis Day, the minister of health and population emphasized the unparalleled Egyptian experience, which has emerged as an inspiring model for nations worldwide. This model encompasses various aspects, including prevention strategies, expediting the pace of diagnosis and treatment, and diligently monitoring disease complications.
In collaboration with the African Union and the African Centre for Disease Control and Prevention, the Ministry of Health and Population has undertaken a sustainable programme to train healthcare professionals from African member states of the African Union. The programme covers all facets of managing hepatitis viruses.
By mid-month, the programme is set to welcome 30 doctors from the first three African countries. This initiative is a natural extension of the president's commitment to treating one million Africans affected by hepatitis C. Egypt, as is customary, exemplifies the finest examples of international solidarity and human cooperation in safeguarding global health security.
Furthermore, the minister highlighted Egypt's remarkable capabilities in the production of modern medications. This proficiency has enabled Egypt to achieve this global milestone, supported by extensive capacities and a commitment to excellence. Consequently, the cost of treatment has significantly declined from $64,000 per patient in 2013 to less than $40 at present, resulting in savings exceeding $2.5 billion in the pharmaceutical import expenditure.
He noted the returns on investment resulting from the president's initiative, estimating it at an impressive 359 percent. Additionally, the initiative has yielded substantial health benefits, estimated at one million life-saving years, and economic savings amounting to approximately EGP 23 billion.
Building upon the programme's success, Egypt has taken a step further by launching a global initiative for the early detection and comprehensive care of liver cancer patients. This initiative is supported by an interconnected network of early detection centres, as well as a network of diagnostic and treatment centres catering to the needs of thousands of targeted patients. Egypt once again exemplifies excellence in providing comprehensive and integrated services.
Leveraging the databases and analysis of the early detection and treatment of hepatitis c initiative, the ministry has extended its efforts to launch early detection programmes with clear objectives. These programmes encompass not only primary liver cancer but also breast, colon, prostate, lung, and cervical cancers.
By maximizing the role of primary care units across all governorates of the country, millions of Egyptians gain access to early examination and detection services. This crucial step aims to alleviate the burden of cancer in Egypt and achieve improved health outcomes for all citizens.
Dr. Mohamed Hassani, assistant minister of health and population for Public Health Initiatives Projects and executive director of the National Committee for Combating Hepatitis, provided further insights into the initiative for the early detection of liver cancer.
He explained that Egypt's success in addressing hepatitis C led to subsequent achievements in the care of liver patients. The country launched two parallel programmes, with the first being the Early Detection of Primary Liver Cancer initiative.
This initiative focuses on conducting regular screenings for individuals at the highest risk of infection, such as those with cirrhosis and patients with the hepatitis B virus. The screenings involve ultrasound examinations and tumour marker tests, which are conducted every four months and provided free of charge.
A total of 75 examination centres have been established to facilitate these screenings, and they are closely linked to 93 advanced centres for comprehensive diagnostic services. In addition, 47 advanced centres specialized in the multidisciplinary treatment of cancerous tumours have been established. Since its launch, this programme has successfully included nearly 116,000 patients from the targeted groups.
Egypt has also made significant advancements in the treatment of liver cancer. In March 2022, the country introduced advanced oral treatments for advanced cases of primary liver tumours. This treatment programme is implemented in 47 liver cancer treatment centres affiliated with the Ministry of Health and Population and the General Authority for Health Insurance. Through a successful partnership with the international company Bayer, the programme has been able to provide treatment to nearly 2,100 patients with primary liver cancer.
Moreover, Egypt has taken a groundbreaking step by introducing the latest global treatment protocols using immunotherapy drugs for liver cancer since May of the same year in six oncology centres across the country, expanding the range of treatment options available to patients.
To ensure the success and effectiveness of these programmes, a comprehensive training and capacity-building initiative has been undertaken. This programme aims to train healthcare professionals, including doctors, nurses, technicians, and data entry operators.
Dr. Adel Adawy, former minister of health, acknowledged Egypt's rich history filled with success stories across various fields. The Egyptian people take pride in their country's leadership in science, arts, literature, and other domains, both in the past and in the present.
Dr. Adawy highlighted that Egypt's leadership in the field of treatment dates back to ancient times, and this legacy continues to shine in the 21st century. Egyptians have consistently demonstrated their determination and resilience in overcoming challenges and tackling epidemics that threaten their well-being.
In the late 20th century, Egypt achieved a significant milestone by successfully eradicating an endemic disease, schistosomiasis, which had plagued the country for centuries, greatly impacting the health of its population. Many individuals present during that time might have personally experienced the devastating effects of the disease on the liver and overall quality of life.
However, by the end of the 20th century, a new health concern emerged in Egypt: the hepatitis C virus. A survey conducted as part of the 2008 Demographic and Health Survey, which analyzed blood samples, revealed that approximately one in 10 Egyptian adults aged 15-59 years suffered from chronic hepatitis C infection.
Until 2007, Egypt did not have a specific programme dedicated to the diagnosis and treatment of the hepatitis C virus, despite the widespread prevalence of this dangerous disease and its significant contribution to mortality rates. The virus is a major cause of liver cirrhosis and an increased incidence of liver cancer among those infected.
From an economic standpoint, the World Bank estimated that the financial burden of the hepatitis C epidemic in Egypt amounted to approximately $3.8 billion annually, which accounted for 1.4 percent of the country's gross national income.
However, by the end of 2011, statistics revealed that only 2.8 percent of diagnosed patients received regular treatment, and just over half of them responded positively to the treatment, representing a response rate of 1.6 percent. In 2013, a significant breakthrough occurred with the introduction of direct antiviral drugs. However, their cost was relatively high, reaching $1,000 for a single treatment course, consisting of 84 pills taken over a period of 12 weeks.
The Egyptian Ministry of Health, in conjunction with the innovative manufacturers of Sovaldi, has made significant progress in reducing the cost of the drug to one percent of its price, bringing the cost of a patient's treatment (84 tablets) to less than $900. The Ministry of Health has further reduced the cost of treatment by producing Sovaldi in Egypt, bringing the price down to $84. This is a major advancement in patient care for those infected with hepatitis C virus.
The 100 Million Healthy Lives campaign was launched as a presidential initiative to demonstrate the political leadership's commitment to providing the highest level of healthcare to Egyptian citizens and eliminating the hepatitis C epidemic, regardless of the cost. The campaign has also created training and educational activities for thousands of healthcare workers.
Dr. Adawy expressed his sincere thanks and gratitude to the partners for the unprecedented success in controlling the deadly epidemic, namely Drs. Wahid Doss, Manal Hamdy El-Sayed, Gamal Esmat, Imam Waked, Ayman Yousry, Magdi El-Serafi, Khaled Qabil, as well as the assistant team, Mohamed Al-Qassas, Mohamed Hassani, and Radi Hammad.
Dr. Ahmed El-Sobky, chairman of the board of directors of the Public Authority for Healthcare, assistant minister of health and population, and general supervisor of Comprehensive Health Insurance, explained that World Hepatitis Day is an opportunity to enhance national and international efforts to combat hepatitis, encourage action and participation from individuals, partners, and the public, and highlight the need to maximize the global response.
Dr. El-Sobky pointed out that the date of 28 July coincides with the birthday of Nobel Prize-winning scientist Dr. Baruch Blumberg, who is credited with discovering the hepatitis B virus and developing a test for its diagnosis and a vaccine.
He noted that the 100 Million Healthy Lives initiative to eliminate hepatitis C in Egypt has achieved great successes. The state has set a higher goal of declaring Egypt free of hepatitis C. Ministry of Health teams have been deployed throughout Egypt with a presidential mandate to screen more than 60 million citizens. This will make Egypt the first country in the world to be certified by the World Health Organization as having eliminated hepatitis C.
He further remarked that the Egyptian state confronted a myriad of challenges in the provision of medicine, particularly innovative medications. The most salient of these were the exorbitant cost of medicine, lengthy patient waiting lists, and the lack of knowledge among those infected with the virus. In response, the state made significant efforts, such as negotiating with pharmaceutical companies to secure lower treatment prices, encouraging domestic firms to produce the drug, and eliminating waiting lists.
He noted that the German company Bayer was one of the first contributors to the 100 Million Healthy Lives campaign, particularly in the early detection and treatment of liver cancer patients.
Bayer provided the necessary oral drugs to treat liver cancer patients, and as part of its sustainable capacity building project, the company worked with the Ministry of Health and Population to train Egyptian and international healthcare professionals using the latest training methods. Bayer also helped to raise awareness of the need for early detection of disease.
He added that this integration and partnership with successful partners from the private sector is part of achieving the dream of integrated healthcare, especially in the era of restructuring the healthcare system, with the comprehensive healthcare insurance project at the forefront.
Hugo Hagen, chairman of Bayer Pharmaceuticals in the Middle East, indicated that the slogan for World Hepatitis Day 2023, "We are not waiting for change...we are striving to achieve it," is a source of pride. He said that the Egyptian Ministry of Health and Population, in cooperation with the international company Bayer, which he has the honour to represent, took the lead two years ago in achieving the slogan of the day.
This was done by launching the initiative for early detection and treatment of liver cancer under the umbrella of the presidential initiative 100 Million Healthy Lives under the supervision of the Ministry of Health and Population and with the participation of German Bayer in Egypt.
Hagen said: On this occasion, I feel even more proud of the remarkable progress that Egypt has made at all levels, especially in strengthening health and healthcare services provided by the state. This progress is truly unprecedented in recent years.
During the launch of the presidential initiatives by President Abdel-Fattah El-Sisi, the state took the lead in launching an initiative to treat citizens from hepatitis C, which was described as an endemic epidemic. The initiative has achieved remarkable results, with 2-6 percent of all people with cirrhosis due to hepatitis C now cured.
Today, we are all proud of the minister of health and population announcing the actual results achieved by this initiative for infected patients. What we are seeing on the ground today is nothing but the achievement of the lofty goal of providing comprehensive healthcare for patients with liver cancer.
The liver cancer initiative, in collaboration with the Egyptian Ministry of Health and Population, is part of Bayer's Global Oncology Sustainability initiative. This initiative focuses on creating equitable ecosystems for cancer care in low- and middle-income countries around the world that experience disparities in cancer outcomes.
The sustainability initiative for early detection and treatment of liver cancer, under the umbrella of the presidential initiative 100 Million Healthy Lives, under the supervision of the Ministry of Health and Population, and with the participation of the German pharmaceutical company Bayer in Egypt, is based on five main axes: developing unified national protocols for the treatment of liver cancer patients in line with international guidelines; covering the needs of liver cancer patients for oral treatments for the first time; building the necessary capacities in cooperation with international experts for early diagnosis and detection of liver cancer patients.
This includes developing local trainers, educating healthcare providers, and establishing platforms to disseminate data through the initiative centres. The other two axes are enabling patients to know about diseases and medicines to improve treatment; and launching national awareness campaigns for liver cancer patients and providing them with a group of patient care and follow-up through call centres and providing consultation.
Hagen noted: I am very proud and honoured that this collaboration between Bayer and the Egyptian Ministry of Health and Population was announced at the US White House Cancer Moonshot as the embodiment of a public-private partnership to improve cancer treatment outcomes in Africa.
In light of the successful cooperation with the Egyptian Ministry of Health and Population and the achievements that have been made, in line with Egypt's Vision 2030 to transform the healthcare system and Bayer's vision of "Health for All, No Hunger," our future vision is now to "Expand into Africa to save millions of lives." Egypt is the gateway to Africa and the meeting point of the civilizations of the ancient and modern world.
He praised the significant transformation in the field of healthcare in Egypt, at all levels, from legislative to organizational to executive. These achievements are in line with Egypt's Vision 2030, which aspires to provide universal healthcare coverage and integrated care to all Egyptians.
The first stage of this plan has already begun with the implementation of the comprehensive health insurance system in six cities. He expressed optimism about the continued cooperation between Bayer, the Ministry of Health and Population, and all other stakeholders to serve the Egyptian patient.
He also highlighted the importance of Egypt’s presidential initiatives, which reflect the long-term strategic plan to achieve the principles and goals of sustainable development in all sectors, especially healthcare, as part of the new republic under the umbrella of 100 Million Healthy Lives.
Dr. Naima Al-Qaseer, the World Health Organization's representative and head of mission in Egypt, said that globally, an estimated 58 million people are living with hepatitis C infection. About 1.5 million people are infected with the virus each year, and an estimated 3.2 million adolescents and children have chronic hepatitis C infection.
She added that the World Health Organization estimated that in 2019, approximately 2.9 million people died of hepatitis C, most of them from cirrhosis and hepatocellular carcinoma. In the past, Egypt was one of the countries with the largest burden of hepatitis C virus globally.
The results of the 2015 Egyptian Demographic and Health Survey revealed that the prevalence rate of hepatitis C was 7 percent among the population aged 15-59 years. During the period 2016-2021, Egypt led the response to viral hepatitis in the Eastern Mediterranean Region, especially with regard to the eradication of hepatitis C. The country implemented a model based on primary healthcare, which has had a significant role in treating one third of the 12 million people with hepatitis C in the region.
Dr. Al-Qaseer added that since the beginning of the first phase of the initiative for early detection and provision of treatment, the strategy was implemented, which was based on an institutional application of health services and public health, based on the global primary healthcare model. There was complete coordination, at the highest level, between the World Health Organization and the Ministry of Health.
She alluded to Egypt's submission of a draft report on the elimination of hepatitis C in 2021, followed by an amended version in 2023, both based on the World Health Organization's (WHO) temporary guidelines to verify the elimination of hepatitis.
She affirmed that they are presently working hand-in-glove with the Egyptian Ministry of Health to update the third iteration of this crucial file in preparation for submission to the regional verification committee, and subsequently, the international one. They are fully committed to working together to ensure that Egypt meets the criteria required to obtain the organization's certification for the elimination of hepatitis C, she pointed out.
Dr. Al-Qaseer reiterated her congratulations to Egypt for making progress towards the global goals of eliminating hepatitis C as a threat to public health. She commended Egypt for accelerating the pace of early detection and treatment through the 100 Million Healthy Lives campaign, and for its sustainability in early detection of the disease and provision of free treatment to Egyptians and non-Egyptians. She also congratulated Egypt for its intensive trend in improving the documentation and coding of deaths, developing and automating information systems, and investigating and following up cases of complications.
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