Dr Amel El Beshlawy, founder of
Egyptian Thalassemia Association (ETA) and Professor of Pediatric Hematology at the Pediatric Hospital of Cairo University, is considered the Middle East’s leading authority on Thalassemia, having made an enduring contribution not only to improving the survival rate of thalassemia patients in her clinical practice, but also to the awareness of a disorder that effects one thousand of every 1.5 million new-borns in Egypt. She speaks about the government-backed program to counter the country’s high prevalence of thalassemia and how the success of other recent screening and treatment initiatives have had a positive impact on advancing this objective.
Can you briefly introduce yourself and your background?
I am a professor of paediatric haematology at the paediatric hospital of Cairo University and gained all my academic credentials from the same institution back in the 1960s and ‘70s. Following that, I was trained at the Necker–Enfants Malades Hospital’s bone marrow transplantation centre in Paris.
Since returning to Egypt, I founded the Egyptian Thalassemia Association (ETA) in 1990, established the Egyptian Society of Haematology, and have become a key member of the American Society of Hematology (ASH), the European Hematology Association (EHA), and the Thalassaemia International Federation (TIF) in the Middle East and Africa (MEA) region.
My career has involved working as the principal investigator on more than 45 international research studies with major international companies. Every year the Egyptian Thalassemia Association holds a conference in conjunction with International Thalassemia Day where we invite international speakers. I have been invited to speak over 100 times at a number of international events.
Why is thalassemia so important to you and what is its prevalence in Egypt?
Thalassemia is very common in Egypt, with the carrier rate ranging between five and a half to nine percent of the total population and many of these cases being discovered by families by chance. Consanguinity does play a role in the high number of thalassemia patients in Egypt but is not the only factor. That is the case for many of the patients in my own clinic. This clinic is probably the biggest paediatric hospital in the Middle East, and the largest haematology clinic treating thalassemia in the region, with more than 3,000 cases annually.
Are any government programs being enacted to counter this high prevalence of thalassemia?
Together with the TIF, the ETA is going to start a program that contains a clear plan to decrease the number of patients born every year with thalassemia. Awareness will grow via educational initiatives around thalassemia in secondary schools, and thalassemia screenings will become part of the process of applying for a driving license in Egypt. Additionally, people applying for a marriage license will require a certificate declaring whether they are thalassemia carriers.
There is a great deal of governmental support for this initiative, both in verbal and financial terms, also the European Union will be granting some funding to build up the program and other related initiatives. Such initiatives have worked well in countries such as Cyprus, and are already underway in other Arab countries. Given the fact that one thousand out of every 1.5 million new-borns in Egypt have thalassemia, the urgency is clear.
Many of the other Egyptian stakeholders we have interviewed are excited about healthcare’s stronger positioning within the government agenda; as a physician on the ground do you feel that this excitement is warranted?
Absolutely. Healthcare has become a very important topic for the Egyptian president, who is able to see the success of governmental campaigns in areas like hepatitis C. This disease was previously very common in Egypt, but thanks to a vast screening and treatment program, its prevalence has been drastically reduced. A similar campaign was launched in screening for anaemia in paediatric patients and for other more common diseases. Now that we are proving our impact in thalassemia, I think the government will act.
Given your involvement in a host of international studies, how would you evaluate Egypt’s potential as a clinical trials hub?
Not only in my specialty or institution but across Egypt, many professors and physicians are participating in international research projects and have done so for the past 25 years. Egypt is an important site for doing research, not only in haematology, but in malignancies, infections, and every aspect of disease.
Clinical trials are ongoing, and there is a clear opportunity in terms of research on diseases which are more common in Egypt than in other parts of the world, making the country an important location for new international research.
What advantages does Egypt have as a clinical trials hub compared to other countries in the region
Firstly, we have the region’s largest population, as well as a host of very eminent professors able to contribute to global research projects. Egypt also boasts an excellent regulatory framework for research, with clear legal guidelines, ethical committees, and insurance for patients entering into clinical trials. While this does sometimes lead to delays, the country overall has a very strong positioning.
Egyptian patients are also eager to enter clinical trials, especially those that have previously participated and have seen the benefits that it can bring.
What has been your experience of interactions with pharmaceutical companies in Egypt? Do you feel there is a need to adjust their approach?
I am very satisfied with how pharmaceutical companies approach physicians in Egypt. They tend to be decent, cooperative, and have always done their homework in terms of which doctor to approach. Their staff are experienced and knowledgeable, having often previously engaged in studies with academia and practicing clinicians.
How confident are you that enough of the new generation of Egyptians will take on scientific careers, as you have done?
Most of the young people I speak to in Egypt are very motivated, with a clear passion for scientific research. We work with a great deal of the new generation at our hospital and university, and I am always impressed by their willingness to work hard, participate, and contribute to research.
