Egypt is currently considered to be at the forefront of hepatitis C virus (HCV) treatment, with Egyptian health officials estimating that the country could eliminate the disease from its national population by 2023 if it scales up its current program, according to a recent article in The Atlantic.

An estimated 1 in 10 Egyptians is chronically infected with the virus — the highest prevalence of HCV in the world — a result of improper sterilization procedures during mass-treatment campaigns initiated 50 years ago to combat a parasitic disease common in the North African nation. In 2015, hepatitis C accounted for nearly 40,000 deaths per year in the country (7.6 percent of all deaths), resulting in a decrease in national GDP growth of nearly 1.5 percent. 

In 2013, when highly effective HCV treatment was first made available to the international community, the Egyptian government responded quickly, saying it wanted to make hep C treatment available to every citizen who needed it. But doing so would either take a significant amount of money (at the time, treatment cost nearly $84,000 per patient in the U.S. market) or significant price bargaining on the part of the Egyptian government.

Egypt decided on the latter, becoming one of the first countries to start price negotiations with Gilead Sciences, one of the first pharmaceutical companies to release next-generation hep C treatment. Gilead ultimately agreed to license its HCV drugs in Egypt and a number of other low-income countries at a price of $300 for a one-month supply, or $900 for a full 12-week course of treatment. Eventually, generic manufacturers drove that price down to just $84 per patient.

Having secured affordable drugs, the nation has become a model for what can happen when large-scale treatment campaigns are implemented. Since 2013, more than 1.6 million Egyptians have received lifesaving medication — more than all the patients treated in the United States and Europe during that period combined.

In 2017, the Egyptian Ministry of health also initiated a nationwide screening program through which more than 260 teams of community health workers go village to village testing people for the virus. So far, they’ve screened more than 1,200 towns, cities and villages,  targeting poor, rural communities.

Meanwhile, less than 20 percent of those estimated to be living with chronic hepatitis C in the United States have received treatment.

What can we learn from Egypt? Click here to read the full feature.