What Nigeria can pick from Egypt’s battle against viral hepatitis

In the fight against viral hepatitis, a global epidemic that is 10 times larger than the global Human Immuno-deficiency Virus (HIV) epidemic, Egypt is the most successful country on the African continent with progressive statistics to show for its commitment to fighting the disease.

Only one in six Egyptians lives with hepatitis C and the result is a product of health structures across the country dedicated to screening, treatment and cure, according to Gilead Sciences, Inc., a research based biopharmaceutical company focused on the discovery, development, and commercialisation of innovative medicines.

Egypt, with a population of 105 million, began its battle with hepatitis C back in 2006, a time when there was no cure for the disease. But today, about 100 million Egyptians have been screened and 50 million treated and cured.

Hepatitis is an inflammatory condition of the liver commonly caused by a viral infection or possibly occurring as a secondary result of medications, drugs, toxins, and alcohol.

Egypt and Nigeria fall in the category of countries with the highest prevalence of hepatitis C, for instance, but while prevalence in Egypt hovers around 2-5 percent, Nigeria’s is at less than 1 percent.

But as a matter of national priority to address the disease capable of wasting lives far more than tuberculosis, malaria or HIV, the Egyptian government worked on the ability of its healthcare infrastructure to handle hepatitis. It focused sufficiently on having enough physicians and personnel trained as well as ensured over 5,000 health centres across the country can welcome patients to screen and follow up their treatments.

Most importantly, keen health observers say there was an overriding political will to put an end to the scourge. And in fact, Egypt is seen capable of achieving the 90 percent reduction in incidence and 65 percent reduction in mortality targets by the World Health Organisation (WHO) by 2030 through the Global Health Sector Strategy on viral hepatitis.

“The key really has been the political will and the engagement at the top of the country to say this is a national priority. A lot has gone into the screening of about 50 million people and treating them. They have done it and will achieve the elimination of this disease by 2030,” Graeme Robertson, Gilead Sciences executive director for Africa, said.

Gilead Sciences was attracted by Egypt’s drive and found the need to leave its footprint in Africa’s road to freedom from viral hepatitis. This brought it closer to the challenge that the infections were rising with a diagnosis rate that didn’t correspond due to limited awareness and access to testing. As a result, it signed an agreement with the African Cup of Nations football tournament to leverage the platform in reaching millions of Africans with the message of getting tested for hepatitis B and C.

At the last African Union Summit, Egypt’s President Abdel Fattah el-Sisi placed viral hepatitis at the high priority of security and development. His vision is to have other African heads of state sign the declaration to ensure real public health sector is funded and the education and training medical staff supported.

Although there are pockets of awareness going on in Nigeria, Papa Salif Sow, vice president, program development and management, access operations & emerging markets, Gilead science, Africa and Geneva, expressed optimism that Nigeria could also win the battle like Egypt if its priority on the disease is strong enough and depending on how fast and urgent it is on the political agenda.

“We have had many government level involvements in Nigeria which is step-one awareness of the issue. It is not obvious and the disease does not show. You don’t know anything until the liver is destroyed. There is political awareness starting come up,” Robertson told BusinessDay at the public briefing of its campaign in Cairo last week.

“We have had many government level involvements in Nigeria which is step-one awareness of the issue. It is not obvious and the disease does not show. You don’t know anything until the liver is destroyed. There is political awareness starting to come up,”he said.

Viral hepatitis is classified into five – hepatitis A, B, C, D, and E – and a different virus is responsible for each type of virally transmitted hepatitis.

Hepatitis A is always an acute, short-term disease, while hepatitis B, C, and D are most likely to become ongoing and chronic. Hepatitis E is usually acute but can be particularly dangerous in pregnant women.

Hepatitis A is most commonly transmitted by consuming food or water contaminated by faeces from a person infected with hepatitis A. Hepatitis B is transmitted through contact with infectious body fluids such as blood, vaginal secretions, or semen containing the hepatitis B virus (HBV). Injection drug use, having sex with an infected partner or sharing razors with an infected person increase risks of getting hepatitis B.

Hepatitis C is transmitted through direct contact with infected body fluids, typically through injection drug use and sexual contact.

Also called delta hepatitis, the hepatitis D virus (HDV) is contracted through direct contact with infected blood. Hepatitis D is a rare form of hepatitis that only occurs in conjunction with hepatitis B infection. The hepatitis D virus can’t multiply without the presence of hepatitis B.