Hepatitis C ravages the liver. It can cause cirrhosis or liver cancer and definitely, untreated, kill you. But Egypt? Egypt’s on it.
Testing for hep C. Photo: Kristin Gourlay
The virus' secret weapon: it lingers. You don't know you're sick until symptoms appear, sometimes decades later, when lots of damage has been done.
In Egypt, health workers inadvertently spread hepatitis C, beginning in about the 1950s, using unsanitary needles. Until a few years ago, Egypt had one of the highest rates of the disease, with more than one in 10 Egyptians infected.
The good news: new drugs hit the market which could cure it.
The bad news: they cost a TON of money.
Here's what Egypt did, and what I hope more countries will do to address the heavy public health burdens--i.e., save lives.
They screened their entire population for the disease.
They negotiated a bulk deal on the medicines.
They got sick people treated and cured. They've nearly eliminated the disease in the country.
According to this great piece from the NYTimes, they're spreading the program to other nations, supporting testing efforts, training doctors, and getting them free or cheap medicine. It's an incredible public health story.
This is a quadruple magic bullet, I'd say. Screen, get the drugs, treat people, replicate. We could do that with so many public health threats. Why aren't we succeeding this way in the U.S., where more than 2.5 million people have the disease? Terrible fact: it's extremely infectious, putting injection drug users who share needles at high risk.
Dr. Francis Collins, former head of the National Institutes of Health, believes the reason is cost. We can't—or won't—negotiate with drugmakers the same way other nations can. We could mount a campaign to eliminate the disease here, but the political will isn't there.
"...we are squandering one of the most important medical advances of the 21st century. It’s time to eliminate this threat to the health of Americans," he said.
So why can Egypt do it, but not the U.S.? We even have a strategic plan. Collins thinks it’s cost. I think there’s something more: the stigma around how people get infected. In Egypt, it was inadvertent. There was blame to lay, but perhaps no moral judgement. In the U.S., the most common route of infection is injection drug use, and, rarely, contaminated transfusions. Why spend money treating people who use drugs, who could relapse and get infected again? And by the way, people who are showing signs of hepatitis C now may have used an injection drug just once in their life, maybe in the ‘60s. That’s all it takes.
Because. Because you can't recover from addiction if you're dead. Because no one should have to suffer from a curable disease. Egypt found the magic bullet. We can too.
Why oh why? could we not do this??!!