Inclusion of refugees and asylum-seekers in the “100 Million Seha (health)” campaign in Egypt

The project in brief

Implemented by

Egyptian Ministry of Foreign Affairs

Country

Arab Republic of Egypt

Duration

The project started in March 2019.

The project is to be completed in 2023 with Egypt attaining its objective of eliminating Hepatitis C.

Description

In March 2019, refugees, asylum-seekers and migrants were included into a national campaign which offers free screening and treatment against Hepatitis C.

Project aims 

The “100 Million Seha” campaign, which kicked off at a national scale in October 2018 under the auspices of President of Egypt, aims at detecting and eliminating Hepatitis C in Egypt by 2023. In addition to Hepatitis C, the campaign includes body mass index measurement, glucose testing for diabetes screening and blood pressure measurement for hypertension screening. The campaign provides free Hepatitis C treatment to the positively diagnosed. Embracing the SDGs principle of “leaving no one behind”, the campaign has started providing free tests and treatment to all legally residing foreign nationals in Egypt including refugees, asylum-seekers and migrants as of March 2019.

By the end of September 2019, 30,000 refugees and migrants underwent the screening of Hepatitis C all over Egypt.

Resources used 

The Egypt’s Chairmanship of the African Union in 2019 with the theme “Year of Refugees, Returnees and Internally Displaced Persons: Towards Durable Solutions to Forced Displacement in Africa” provided the necessary policy support to the Ministry of Health and Population (MoHP) to include refugees and asylum-seekers in the campaign.

WHO Director General, Tedros Adhanom, on a visit to Egypt in August 2019 acknowledged Egypt’s “100 Million Seha” medical initiative as the biggest campaign to be implemented by a state.

Partners

• Ministry of Health and Population of Egypt
• National Hepatitis Committee of Egypt
• World Health Organization – Egypt Country Office
• United Nations High Commissioner for Refugees – UNHCR Egypt Representation
• International Organization for Migration – IOM Regional office in Cairo
• Caritas Egypt
• Suryana center

Challenges and how they were overcome

Challenges

• When refugees were included in the campaign in March 2019, some of the referral testing centres were still receiving a significant number of Egyptian citizens for complementary investigations. This posed challenges in terms of increased waiting times and crowded environments at the testing centres;
• Some refugees and asylum-seekers were initially hesitant to come forward to the MoHP testing centres.

How they were overcome

• Radiology and/or laboratory investigations that could be done by UNHCR medical partners to overcome waiting time at the testing centres were readily offered to refugees and asylum-seekers in order to speedily finalize the assessment for treatment eligibility;
• MoHP organized outreach activities in coordination with UNHCR, WHO and IOM in Cairo, Alexandria and Damietta which facilitated access for refugees or migrants who were initially hesitant to come forward at MOH testing centers.

Results of the Good Practice 

Some 30,000 refugees, asylum-seekers and migrants and more than 60 million nationals were screened for Hepatitis C since 2018. They were also rendered aware how to protect themselves from Hepatitis C and other blood transmitted diseases risks to enjoy a healthy living.

Tested citizens, refugees, asylum-seekers and migrants who were found positive to the test and clinically eligible for treatment received free antiviral treatment from the MoHP. By having their viral load reduced, the virus transmission risks will be interrupted. This will contribute to Egypt’s Hepatitis C elimination by 2023 and the global objective of elimination of Hepatitis C by 2030.

How the project contributes to the GCR Objectives

Objective 1: Ease the pressure on host countries

Early detection and treatment of Hepatitis C will prevent the chronic liver disease complications risks and reduce the pressure posed on emergency and hospital care in Egypt, as a host country offering primary and referral hospital care services that are stretched by an already population of 100 million citizens.

Objective 2: Enhance refugee self-reliance

Promoting healthy living and well-being through early detection of communicable diseases as Hepatitis C helps refugees and asylum-seekers to avail themselves of a best fit to engage in livelihood activities.

Next steps 

The campaign is part of Egypt’s 2030 Sustainable Development Strategy (SDG) which foresees an integrated approach to sustainable development. The Government of Egypt aims at providing a Universal Health Coverage (UHC), including financial risk protection and access to quality essential health care services for all the Egyptian citizens.

In order to achieve the UHC for all its citizens, the Government has adopted a national law and related bylaws which include a provision stipulating that refugees can enjoy health insurance services within specific insurance schemes. With the roll-out of the UHC, all paths leading to the inclusion of refugees and asylum-seekers into a sustainable Universal Health insurance on equal footing to nationals will need to be pursued.