NOhep Supporter Spotlight – Ammal Metwally

Egypt’s hepatitis C burden is one of the highest in the world. In 2015, an estimated 6.3% of the population were living with chronic hepatitis C infection.

However, Egypt is now fighting back. The government aims to eliminate hepatitis C by 2023. In the past year alone 5 million people have been screened for hepatitis B and C. On 1st October, the government launched a new $561 million initiative to screen another 50 million people. Key to this success is a thriving network of civil society organisations. Ammal Metwally of the Association of Liver Patients Care (ALPC) shares how she’s been driving action.

“Community and patient engagement is key for success. Local behaviours and practices cannot be changed without creating a model that is community-based and community-led”

My involvement in advocating for the elimination of viral hepatitis, at the national and community level, started in 2010. As a public health and community medicine specialist with the National Research Centre (NRC), I was a member of the task force that set the prevention component of Egypt’s national strategy for elimination from 2012 to 2018. I was also involved in putting the implementation plan into action.

With a team from the NRC, I produced educational and promotional materials directed towards the public and medical professionals to change risky behaviours through the use of infotainment.

We created four Arabic booklets, nine Arabic 3D animation cartoon films (each 2-3 minutes) and a song. They conveyed optimistic messages, addressed stigma and moved awareness into action.

At the community level, as part of ALPC, I helped plan and start our innovative project ‘Towards a village free from viral hepatitis’.

Since May 2015, this project has aimed to establish an exemplary village free from viral hepatitis through implementing community based outreach interventions. As well as providing treatment and care services that address hepatitis B and C.

This project is intended to complement Egypt’s existing national treatment programme and support our national goal towards elimination, particularly as an important strategy for rural settings.

On 7th of May 2016, ALPC declared 10 villages in Egypt to be free from viral hepatitis. Our model of elimination in one village in northern Egypt was also published in the Lancet.

We declared 30 villages as free from viral hepatitis in May 2017 and are now working to declare another 63 by the end of 2018.

To establish and successfully create a hepatitis-free village, a comprehensive and integrated approach, that incorporates both preventive measures to reduce transmission and new infections as well as testing and treatment to reduce burden of disease, is key.

Community and patient engagement is another key for success. Local behaviours and practices cannot be changed without creating a model that is community-based and community-led.