On 12 October, on the sidelines of an event highlighting advances in stroke management and awareness in Egypt, Ahram Online interviewed Dr. Hussam Salah, Dean of the Faculty of Medicine at Cairo University, and Prof. Mohamed Meshref, General Manager for Northeast and West Africa at Boehringer Ingelheim, to shed light on the growing burden of stroke, the importance of early intervention, and Egypt's breakthrough treatment for acute ischemic stroke.
Ahram Online (AO): Stroke is often described as a medical emergency that can strike without warning. Could you briefly explain what exactly happens in the body during an ischemic stroke?
Dr Hussam Salah (HS): Strokes strike suddenly and without warning.
In the case of an ischemic stroke, what happens is that a clot blocks one of the arteries supplying blood to the brain. This interruption in blood flow deprives brain tissue of oxygen and nutrients, leading to the death of brain cells within minutes. The symptoms depend on which part of the brain is affected. Typical symptoms include weakness or numbness in one side of the body, slurred speech, or difficulty maintaining balance.
Often, patients or their families notice these symptoms early in the morning, which is when many strokes tend to occur. Detecting the exact time of onset is crucial because many treatment protocols depend on how quickly the patient receives medical care.
AO: What are the main risks that increase the likelihood of stroke, and what simple preventive measures can people take to reduce their risk?
HS: In Egypt, as in most countries, the main risk factors include high blood pressure, diabetes, obesity, high cholesterol, and smoking. Lifestyle habits such as physical inactivity and unhealthy diets play a significant role. The good news is that most of these risks are preventable.
We can protect ourselves by adopting a healthier lifestyle, like eating balanced meals, exercising regularly, quitting smoking, and managing stress.
Mental health is also essential; high stress levels and poor sleep can contribute to cardiovascular problems.
AO: The numbers in Egypt and globally are alarming. Could you share some key statistics that highlight the scale of the problem and why urgent action and awareness are needed?
HS: We are seeing an increasing number of stroke cases globally, and Egypt is no exception. Research shows that Egypt has one of the highest rates of stroke in the region, with a relatively young population being affected; many patients are under 50 years old. That's particularly concerning because a stroke in a younger age group means a loss of productivity and greater economic and social impact.
Unfortunately, awareness remains low, and many people don't recognise the warning signs or delay seeking medical help. This is why continuous education and nationwide awareness campaigns are essential.
AO: What steps do you believe are crucial to raise awareness about the early signs of stroke and the importance of rapid medical response?
HS: The most critical step is public education. People need to recognise the early signs of stroke, summarised in the acronym F.A.S.T.: Face drooping, Arm weakness, Speech difficulty, and time to call emergency services—every minute counts.
Equally important is training healthcare professionals at all levels to quickly identify stroke symptoms and refer patients to specialised stroke centres.
Egypt has already made significant progress in this area through governmental and presidential health initiatives and by establishing more stroke-ready hospitals.
AO: What distinguishes the new treatment, Metalyse, from other treatments currently used for acute ischemic stroke?
Prof. Mohamed Meshref ( MM): It is a thrombolytic agent that helps dissolve blood clots faster and more effectively. Unlike older medications, which require continuous infusion, Metalyse is given as a single intravenous shot. This makes the process much quicker and simpler for doctors and patients.
The treatment allows for quicker restoration of blood flow, which can lead to better outcomes when administered promptly.
AO: Egypt is the second country in the IMETA region to launch this medication. What factors made Egypt an early adopter of medicine?
MM: Egypt has become one of the fastest countries in the region when it comes to adopting innovative healthcare solutions. The Ministry of Health has played a key role in streamlining the registration and approval process for essential medications, especially those with a high public health impact.
In the past, registering a new drug could take two years or more. Today, through improved collaboration and prioritisation, innovative drugs can reach the Egyptian market in less than a year. This reflects the government's firm commitment to bringing advanced therapies to Egyptian patients as quickly as possible.
AO: How does Boehringer Ingelheim view its role in supporting Egypt's healthcare system, particularly in advancing medical research and innovation?
MM: Boehringer Ingelheim has a long history in Egypt; in fact, it was the first office the company opened in the Middle East back over 60 years ago, in 1961.
Egypt is a core country for us, not only because of its large population but also because of its strategic role in the region.
We invest around 25 percent of our global revenues in research and development, one of the highest rates in the pharmaceutical industry.
In Egypt, we are committed to supporting clinical research and have recently resumed clinical trials after a period of suspension, thanks to new legislation that has made research more feasible.
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