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Hepatitis: a growing challenge

by The Reporter Magazine
May 1, 2020
Hepatitis: a growing challenge - Ethiopian Magazine | Ethiopian News
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Bassem Bibi has more than two decades of experience in the medical equipment industry, specializing in interventional cardiology, vascular, endovascular, cardiac surgery and orthopedics. In 2019, Bassem joined Abbott’s Rapid Diagnostics business as Vice President and General Manager for Infectious Disease focusing on emerging markets and Africa. From 2015 to mid-2019, Bassem was Regional Director and General Manager of Sub-Saharan Africa for Johnson & Johnson Medical Devices and Diagnostics (MD&D). In that role, he established a network of 28 distributors across the region, increased sales by 72 percent in his first two years, and led and developed a staff of 45 professionals into a high performing team. During a decade at W.L. Gore & Associates, Bassem advanced through a series of sales positions to become Regional Sales Director of Eastern Europe, Middle East, and Africa. From 2000-2004 at Guidant, he was a Clinical Specialist and Sales Manager for the Middle East and Northern Africa. Recently he was in Addis Ababa and Birhanu Fikade of The Reporter Magazine caught him to learn about the growing concerns and the measures to control the hepatitis B and C viruses in Africa. He explains how countries including Ethiopia are exerting efforts and how Abbott as a medical device manufacturing company is collaborating to eliminate the viral infections from hepatitis. Excerpts:

The   Reporter   Magazine:   Why is  Hepatitis C   Virus   (HCV)  is becoming  viral  in  Africa? And what are the conducive settings catalyzing the HCV  infection to rise in the continent?

Bassem  Bibi:   It is not because it is Africa that  infections  of HCV are  growing. Developed countries and regions also are having this infection, too.  Now  we  are focusing on  it since we  didn’t do  that well before. As  Abbott, a company that prioritizes willingness, we are trying to eliminate this disease at all. We are trying a different method in screening the virus.

How serious are the threats that this  diseases  pose to   Africa  or other developing regions?

It is a serious virus. In Ethiopia, HBV   infection is  prevalent, some 5.6 million people are infected out of  the  general population. For Ethiopia, 5.6 million people represent 5.6 percent of the entire population. Based on the World Health Organization (WHO) figures, Ethiopia has many numbers of people living with HBV. This is a very dangerous size. We can cure HVB  through vaccinations. But it’s difficult to cure HCV.  Yet,  if we  can detect HCV at the early stage, there is  a  possibility that  we can cure patients. If we could consider Egypt, for  instance, we have screened 60 million within seven months  and we  have saved many families. We are trying the same to be applied in many  African countries. We  have a project in Madagascar, Morocco, and we  are trying here to  push the need for  screening. But we are at an early stage. We  have tested close to 70 million in Africa so far.

It is a serious virus. In Ethiopia, HBV infection is  prevalent, some 5.6 million people are infected out of  the  general population. For Ethiopia, 5.6 million people represent 5.6 percent of the entire population. Based on the World Health Organization (WHO) figures, Ethiopia has many numbers of people living with HBV. This is a very dangerous size

Mortality  rates  from various Non-Communicable Diseases (NDCs) are greater  than  the rest of communicable  illnesses in Ethiopia. From that point of view, where does HCV stands in the country? How is the condition in other African countries?

Each country has its status and circumstances. When we  talk about HCV  mortality rates, what is in Uganda or Rwanda is different than what is in Ethiopia. If  you   look to Sierra Leone, you might find it only being a seven million population and that makes the comparison a bit difficult. Of course, they have a higher percentage of prevalence as Ethiopia has. We have a testing tool that helps pregnant women to be checked for HBV, HIV/AIDS, Syphilis and TB. HBV is a core virus that highly exposes patients for HIV/AIDS and when you have HIV/ADIS it will lead you to have HVB. Hence, we put all these into a testing requirement to protect unborn children from infections. The test doesn’t require any sort of infrastructure or you don’t need to have electricity, or you don’t have to have well-furnished health facilities. The testing procedures could be undertaken under the shed of a tree. But it can save a lot of children being born with the virus. We started the testing procedure for antenatal testing in Rwanda. the President, First Lady and the Minister of Health were very focused on this project. They have built small health care units around villages. Previously, in rural areas, it will take three hours for people to get to health care facilities but now eight newly built units have enabled some villagers to spend 30 minutes to get to these facilities. The plan is  to construct  30 health units that could facilitate early testing procedures.

What   are   the   costs   families bear as a  result of  the Hepatitis virus? Are any indicative studies available with you?

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We must differentiate HBV  from HCV.   HCV is not a burden on a family. It can be cured. But it’s different when we  talk about HBV. Most  families  don’t  want  to   talk about it open and it will not be cured entirely. There is a treatment for HVB, and it might take time. The problem, however, is that most of the time people don’t talk about it. It is necessary to make people aware.You don’t need to hide if you are infected. When people realize that there is help available around them,it is easy to get them treated and help them have a normal life.

Do you mean a lack of awareness is a factor for the virus to become more contagious?

That’s true. We should send out the message not only to big cities and to try to aware people. We must focus on rural communities as well. We must go there. There are creative ideas that could facilitate reaching people living in remote areas. But we must join hands. Stakeholders, governments and companies such as ours must cooperate and fight the spread of viral infectious diseases.You might have a mobile bike clinic to offer the testing kits to rural areas and try to create awareness campaigns.

You have mentioned how the hepatitis virus infects children and could we know the prevalence rate among this age group?

According to the WHO estimates some six million children are living with HBV.

What does that mean to Africa in general and how do you put Africa in comparison to other developing regions for HVB?

Leaders of many African countries are focusing on tackling the disease.They are moving in the awareness campaigns. There are global support mechanisms for Africa to help eliminate the disease. I believe, FIGHTING HEPATITIS in 2030 we will be extremely in a better condition than we are now. The efforts of Abbott and other companies working on hepatitis will contribute towards that end.

According to reports by the end of 2030, Africa is expected to be free from HVB infections. What are the hopes the medical world has to facilitate the continent to achieve its targets?

I will tell you what Abbott has been doing and willing to be doing about hepatitis treatments. We have developed a simple to use and a very effective testing kit that can be made available anywhere.It is the technology we have right now.The future is more exciting, but I can’t tell you exactly what it would look like.

What makes hepatitis spread so quickly and become viral?

It could be your lifestyle. HBV can be transmitted in so many ways. Sometimes, if you have HCV then that might expose you to contract HVB when you fail to receive treatments and take care of yourself. HIV is the major factor that will expose one to be infected with HVB. Excess use of alcohol, usage of dirty needles to inject drugs, men having sex with men, hygiene and the like are some of the critical leading factors for hepatitis virus infection.

What concrete results we might expect from your engagements with the Ethiopian government?

We are still working on that. But the government is proactive, and the people of Ethiopia are curious about
public health. I can’t say we are going to finalize deals in just about three or four months. It’s  a long-term engagement and it depends on how we are moving towards achieving targets.

Let  me  put myself in the shoe of  the Minister of  Health and want to  see how Abbott could convince me how I need  to have this company’s services in Ethiopia?

It’s  not about convincing the authorities. They are the ones pushing it for  the better of society. They are trying to  have as  many companies as possible they can to tackle hepatitis. They know what best serves their interest better than we do.

Many  suggest  that  hepatitis C  and  B  viruses  are getting viral. But what remedies does Africa  have  to contain  the virus before it gets to become an epidemic?

Some many parameters and programs can be  applied. I have mentioned what we have done in Egypt. We have traveled to places and conducted screenings and testing. Now,  we are reaching to Uganda, Nigeria, Sierra Leone, and many countries. Almost all  African governments are working towards controlling this disease. All are aligned towards fighting hepatitis in Africa.

Is there any likely scenario in Africa for   hepatitis infection epidemics any time soon? Should we  worry  for   it will happen in the coming two or three years?

If you  mean people who couldn’t get  tested for  the virus, that is something  we   should  work  on but in my opinion, I don’t see the hepatitis epidemic will strike Africa. But numbers  might  be different when more people are tested.

Which countries are doing better in regulating hepatitis infections down?

Uganda and Rwanda are showing remarkable signs of progress. Kenya is also working on that track. Similarly, South Africa and Tanzania are on the path. East African countries are doing a great job  and they are advancing. Nigeria is joining the race.

Could you  monetize  or   give us  financial   numbers  what it  means  to    test  and  treat for  instance 5.6 million Ethiopians  infected  with HVB?

To be honest, I don’t have such a figure and I am not the right person to talk about that. It is the government that should tell you that.

How well will Abbott provide the  needs if  they  decided to have   you   onboard?  Would you deliver all  the required testing kits at  once?

We can deliver all requested equipment and kits. We have the capability. We don’t think just business, but we value how many lives we could help to save.That’s our priority and reaching out for patients and families for healthcare needs is what we aspire for. But if there is a need to test the whole population,we can deliver all the materials right away. We did that in Egypt and we can do it in Ethiopia,too. When the government of Egypt requested us to deliver all the required testing materials and equipment, we did that in a very short period. The best approach for fighting hepatitis is to be quick to finalize tests and provide treatments at the early stages. In six months,Egypt succeeded to contain hepatitis and two million people are currently remaining infected and since we knew that providing treatments and saving lives has become easier now.But everybody has worked as a team to achieve that. From the Egyptian President all way down to our team we have worked hard in a coordinated approach.

If the government of Ethiopia wants Abbott to be involved, does that mean the company will open manufacturing units in the country?

We don’t set manufacturing plants outside our premises. We are a US-based company and our production mostly remains to be there. What we do is that we might receive orders and manufacture those medical tests and lab equipment according to the interests of clients. But we don’t do manufacturing outside of the US.

Assume that we might meet next year. What will be the story you might share with us?

From my lists, my top priority country is Ethiopia and its people. We are working very closely with the government. Currently, we are in an early stage and discussions are ongoing. The technologies we have for screening and testing is not limited to hepatitis. We have effective testing tools for malaria and many diseases.

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