Listen now to snippet “Egypt Finds Low-Cost Treatment for Hepatitis C” from Great Moments in Science. The government implemented a program to screen and cure.
Publish Date: Dec 28, 2020
Today, hepatitis C infects about 1% of the world's population, and it kills around 400,000 people each year. The World Health Organization, or W. H O, announced its first guidelines for treating hepatitis C in early 2014. At that time, the treatment was so expensive, the W H O said, and I quote Hepatitis C treatment is currently unaffordable to most patients in need. Unquote, this was a crying shame because the treatment had a success rate of up around 95%. Now the treatment works best when given early in the course of the disease before the patient develops cirrhosis of the liver, which kills two thirds of those who died from the disease or cancer of the liver, which kills the remaining one third. Hepatitis C is usually transmitted via blood that is already carrying the virus, and hepatitis C is one sneaky disease. Most people who get it around three and four of them don't even realize that they have been infected because the symptoms could be quite mild and vague for a long time. And in about one quarter of everybody who catches hepatitis C, the disease will just spontaneously vanish all by itself, leaving them completely disease free, but with no treatment. The people whose infection doesn't just disappear well, they end up with a long term chronic infection. They often have almost no symptoms for a few decades 10, 20 or 30 years. But after about 20 years of infection, the risk of cirrhosis of the liver increases and once cirrhosis kicks in, the risk of liver cancer increases. Now, while the worldwide incidents of hepatitis C is around 1% it's around 2% in the Yusa and a devastatingly high 10% in Egypt. The figures are so high in Egypt because of poor medical practice between the 19 fifties and the 19 eighties. Back then, the country was ravaged by another awful disease, schistosomiasis, which is caused by a parasitic flatworm. The good news was that the Shister surmises, could be treated successfully by an injection. The terribly bad news was that the needles were reused from one person to the next and to the next. If one person in the chain carried hepatitis C, then everybody else who was later injected with the same needle also got hepatitis C. In 2015 Theirry Gyptian government carried out a survey to try to work out how much Hep C was in their country. In their survey of people 15 to 59 years of age, about 10% had been infected, while about 7% carried active virus, scaled up to their population of 95 million. This meant that about 5.5 million people had chronic hepatitis C infection, and in turn, this meant a huge burden both in health and in economics. Theirry Gyptian government bit the bullet and decide to screen some 62 million people and treat them in just one calendar year. Wow, You would expect that this would cost a bomb, and you would wonder how Egypt could afford it. Well, the economics were interesting, to say the least. On one hand, Egypt estimated that, and I quote the lifetime direct medical costs and indirect cost of disability and early death for patients unquote with hepatitis C. Infection was mawr than 100,000 U. S. Dollars each. That's enormous in terms of people and money. On the other hand, the cost of drugs to treat each person carrying hepatitis C had dropped from his high as $84,000 to $1650. Better but still why too expensive? Three Egyptian government, with help from the World Health Organization, was able to negotiate a much more reasonable price. They were able to bring down the total cost off screening, identifying, diagnosing and curing a patient to just $130.62 US. Wow. Suddenly it was very doable. The program was entirely voluntary. Nobody had to be screened. But 50 million of the 62 a half million potentially infected population spontaneously got themselves screened in the seven months following October 1, 2000 and 18. Mobile screening teams, and especially outfitted vehicles cross the country in peak and off peak times. If a patient tested positive to a finger prick rapid diagnostic test, the result was available within 20 minutes, and then that patient was immediately scheduled for a follow up within 2 to 5 days. They also received abdominal ultrasound to see if they had cirrhosis of the liver. If they did not, and the liver was still healthy. They took the drug treatment for three months, but if they did have cirrhosis it was six months a disease that would have cost the economy $100,000 U. S per person was being wiped out for $131 U. S. Per person. This is such a good news story. Unfortunately, this cheap your is not being implemented worldwide. Part of the reason is that in the wealthy countries, the people who have hepatitis C are often highly marginalized. They're in jail or they have injected drugs in the past. And another problem is that privatized medicine is much more expensive than public medicine. The World Health Organization has a global goal off eliminating hepatitis C. By the year 2030. It's the right thing to do. It's cheap, and in the long term it actually saves money for the country that carries it out. What's not to like?