Egypt and Ghana Team Up To Eliminate Hepatitis C

John Ward, director of Global Coalition for Hepatitis Elimination, and Yvonne Ayerki Nartey, a physician at Cape Coast Teaching Hospital in Ghana and a research fellow for the Coalition of Global Hepatitis Elimination at Task Force headquarters in Decatur, Georgia in May. Photo courtesy of Monica Fambrough

Egypt has begun supplying Ghana with medicine to treat hepatitis C, a unique collaboration that marks a turning point in their national efforts to combat the disease. The first shipment of drugs was delivered in March at a ceremony in Accra, with top Ghanaian health leaders receiving the medicine in a ceremony with Egypt’s ambassador. Egypt has pledged to supply Ghana with medicine to treat 50,000 Ghanaians with hepatitis C. Patients will receive the drugs free of charge.

Viral hepatitis kills more people around the world than HIV, malaria and tuberculosis. Twenty-six percent of the global burden of viral hepatitis is in Africa. If successful, this collaboration may chart a path for more partnerships between African nations to address this and other continent-wide health issues.

Egypt and Hep C

Less than a decade ago, the idea that Egypt would be in a position to help other nations fight hepatitis C seemed far-fetched. Egypt was a country where global health professionals could look to see the scourge of viral hepatitis at its worst. For years it suffered the world’s highest prevalence of hepatitis C infections. Roughly 10 percent of Egyptians were believed to be infected, with hepatitis C killing an estimated 40,000 Egyptians in 2015 alone.

That year Egypt launched a massive national program to eradicate hepatitis C. The program leveraged new, more effective treatments, agreements with global pharmaceutical firms to allow less expensive local drug manufacturing, and critically, had strong commitments at all levels of Egypt’s government.

By 2021 Egypt’s hepatitis C program had screened 60 million Egyptians for the infection, treating 4 million of them.

Egypt is on pace to eradicate hepatitis C from the country this decade. From an example of the problem, it quickly became a country where global health professionals look to see public health solutions.

“It’s one of the all-time public health accomplishments. Certainly one of the greatest of this century,” says John Ward, director of Global Coalition for Hepatitis Elimination at Task Force.

Ghana and Hep C

For Ghana, the medicine shipment amounted to a public launch of its own national program to eradicate hepatitis C from the country by 2030. Talks on a Ghanaian-Egyptian collaboration to end hepatitis C in Ghana began during summer 2022, Ward says. Those talks coalesced into a formal declaration in October 2022 by a UN Group of Friends to reduce Hep-C infections by 90% by 2030.

Ward credits Dr. Yvonne Ayerki Nartey, a physician at Cape Coast Teaching Hospital in Ghana and a research fellow for the Coalition of Global Hepatitis Elimination, with helping lay the scientific groundwork for this intergovernmental collaboration. Nartey assessed the testing and treatment capacity for viral hepatitis in Ghana, and evaluated the seroprevalence of Hepatitis B and C. 

“Yvonne did a spectacular assessment,” says Ward. “Her work helped find that one-in-20 people in northern Ghana were infected.”

Nartey says Ghana’s new program, called Stop Hepatitis C, could produce actionable lessons for other lower- and middle- income countries trying to eliminate hepatitis C. Together with Dr. Atsu Seake-Kwawu, the program manager for the National Viral Hepatitis Control Program of Ghana, and other stakeholders, including the Hepatitis Alliance of Ghana and the Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD), Nartey is working to implement Stop Hepatitis C in regional and teaching hospitals in Ghana. Along with eliminating enormous out-of-pocket costs for medicines, Ghana’s program aims to eliminate or lower other barriers to care, including the cost and availability of testing, and making treatment available outside of large specialist or teaching hospitals.

“Stop Hepatitis C has expanded treatment to centers where care may not have previously been available,” Nartey says. “For example, we now have a treatment site at Sanderma District Hospital in the Upper East region. Without this project, people living in that area would have had to travel 220 kilometers to the nearest teaching hospital to receive treatment.”

“This is not easy for Ghana. It’s a country with modest financial resources,” says Ward. “But it’s a very positive step forward.”

Egypt’s generous support, made possible by its own successful efforts, combined with Ghana’s determination to eradicate the disease within its own borders, offer hope for people across the continent. If successful, this collaboration could set precedents for how lower and middle income countries can help millions affected by hepatitis C and other diseases worldwide.

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