Context: According to the World Health Organisation 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.

What is Gold tier status?

It 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.

• The establishing of a sentinel surveillance Programme for hepatitis sequelae, including liver cancer.

How did Egypt achieve this status?

• Stringent Criteria: To reach the “gold tier,” Egypt fulfilled specific criteria, including ensuring 100% blood and injection safety, providing a minimum of 150 needles/syringes annually for people who inject drugs, diagnosing over 80% of individuals with chronic hepatitis C virus (HCV), treating over 70% of diagnosed HCV patients, and establishing a surveillance program for hepatitis sequelae, including liver cancer.

• Exemplary Results: Egypt has diagnosed 87% of its hepatitis C patients and provided curative treatment to 93% of those diagnosed, surpassing the WHO’s gold tier targets.

• “100 Million Healthy Lives” Initiative: Egypt’s ambitious initiative led to a substantial reduction in hepatitis C prevalence, from 10% in 2016 to 5% in 2018 and an estimated less than 1% in 2019, as reported by the Africa CDC.

• Leadership Role: Egypt extends support to other African countries, aiming to replicate its success in hepatitis C elimination, including enhancing access to affordable treatment.

About Hepatitis C

• It is a viral infection that affects the liver.

• It can cause both acute (short term) and chronic (long term) illness. It can be life-threatening.

Transmission

• It is spread through contact with infected blood.

• This can happen through sharing needles or syringes, or from unsafe medical procedures such as blood transfusions with unscreened blood products.

• It can be passed from an infected mother to her baby and via sexual practices that lead to exposure to blood.

• Hepatitis C is not spread through breast milk, food, water or casual contact such as hugging, kissing and sharing food or drinks with an infected person.

• Symptoms: It can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and yellowing of the skin or eyes (jaundice).

Geographical distribution

• This virus infection occurs in all WHO regions.

• The highest burden of disease is in the Eastern Mediterranean Region and European Region.

• New HCV infections are usually asymptomatic, few people are diagnosed when the infection is recent.

• In those people who develop chronic HCV infection, the infection is often undiagnosed because it remains asymptomatic until decades after infection when symptoms develop secondary to serious liver damage.

• There is no vaccine for hepatitis C, but it can be treated with antiviral medications.