The most common route of hepatitis C virus spread is injection drug use
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On October 9, WHO announced that Egypt had made “unprecedented progress” towards eliminating hepatitis C. According to the WHO, Egypt became the first country to achieve “gold tier” status on the path to elimination of hepatitis C as per the global health body criteria.
The “gold tier” status to reach the stated goal of eliminating hepatitis C includes meeting specific criteria such as ensuring 100% blood and injection safety, maintaining a minimum of 150 needles/syringes per year for people who inject drugs (PWID), diagnosis of over 80% of people living with chronic hepatitis C virus (HCV), treating of over 70% of individuals diagnosed with HCV, and the establishing of a sentinel surveillance programme for hepatitis sequelae, including liver cancer.
Egypt has diagnosed 87% of people living with hepatitis C and has provided 93% of those diagnosed with curative treatment, exceeding the WHO gold tier targets of diagnosing at least 80% of people living with hepatitis C and providing treatment to at least 70% of diagnosed people, the WHO said.
Egypt had undertaken the “100 Million Healthy Lives” initiative. Through this initiative, Egypt “significantly reduced the prevalence of hepatitis C from 10% in 2016 to 5% in 2018 and an estimated less than 1% in 2019”, the Africa CDC said.
“Egypt’s journey from having one of the world’s highest rates of hepatitis C infection to being on the path to elimination in less than 10 years is nothing short of astounding,” Dr Tedros Adhanom Ghebreyesus, WHO Director-General said in a statement. “Egypt is an example to the world of what can be achieved with modern tools, and political commitment at the highest level to use those tools to prevent infections and save lives. Egypt’s success must give all of us hope and motivation to eliminate hepatitis C everywhere.”
“With its commitment to eliminate hepatitis C, Egypt has succeeded in testing virtually the whole of the eligible population and has treated almost all those who are living with the virus. This represents one third of the 12 million people living with hepatitis C in the Eastern Mediterranean Region,” Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean said in a statement.
According to the Africa CDC, Egypt was able to achieve huge success with hepatitis C due to key interventions undertaken including population-based surveys to understand the hepatitis C epidemic (who is affected and where) and developing an investment case to highlight the economic burden of HCV. Egypt also customised the elimination programme by involving generalist doctors to community healthcare workers and using telemedicine for hard-to-reach areas. But the biggest boost came from reducing the cost of medical treatment per patient to less than $50 through local manufacturing.
Egypt is now taking a leadership role with its commitment to support other African countries to replicate its success, including enhanced access to inexpensive drugs to treat hepatitis C.
Hepatitis C infection is unevenly distributed globally, with these regions accounting for the most — European (22%), South-East Asia (20%) and the Eastern Mediterranean (17%). According to a 2023 WHO document, in 2019, there were 1.5 million new infections, with one third of new HCV infections occurring in the Eastern Mediterranean Region. The prevalence of hepatitis C across the world in 2019 was 58 million.
Though unscreened blood and blood products and inadequate sterilisation of medical equipment in health-care settings are two important routes of virus transmission, the most common route of virus spread is through unsafe injection practices such as sharing needles, syringes, or any other equipment to inject drugs. The use of safe injections has however reduced new hepatitis C infections.
