Marco Zaki, a researcher at the Egyptian University of Minya, inside his research laboratory to find liver cancer treatments

Egypt faces a formidable health challenge regarding liver diseases. With the highest prevalence rate of hepatitis C virus, and the second highest of liver cancer worldwide, the burden of liver diseases in Egypt remains extremely grave affecting health, economy, and development. Some studies indicate that the economic burden of liver diseases in Egypt will reach US$89 billion between 2015 and 2030 if the status quo continues. Here comes the role of scientific research to find solutions to liver diseases aggravating challenge. Hence, the Newton-Mosharafa Fund targets healthcare as one of its priorities to support scientific research and innovation in Egypt.

The £50 million Newton-Mosharafa Fund seeks to support scientific research in Egypt by developing partnerships between Egyptian and UK research institutions. The fund provides the opportunity to build capacities and skills, enhance research cooperation between the two countries, and transfer innovation, knowledge, and expertise.

Below are three inspiring stories of Egyptian male and female researchers seeking to address liver diseases and complications at various levels, through discovering low cost diagnostic methods for liver cancer, finding immunotherapy to treat it, and developing diagnostic tools for its early detection.

Low-cost Liver Cancer Diagnosis

The Hepatitis C virus infection rate in Egypt is approximately 10% to 15% of the population over the last three decades. It causes many health complications that worsen to lead to liver cancer. This has led to a high incidence rate of liver cancer among other types of cancer, representing about 33.5% of all cancer cases in males, and about 13.5% in females in Egypt. The diagnosis of liver cancer relies mainly on ultrasound and computer-based CT scans, which are often not available. Developing tools for diagnosing and detecting liver cancer with limited resources is what Imam Waked, a professor at the Egyptian National Liver Institute, is working on through a research project in partnership with Imperial College London, UK.

This research project looks for biomarkers that can be found in blood or urine samples indicating liver cancer, and then diagnose it in an easy and simple way in its early stages. This has already been confirmed by Waked and his research team by detecting metabolic compounds in the urine indicating liver cancer at a very early stage. Waked hopes to use this discovery to develop a simple test - similar to a home pregnancy test - for early diagnosis of liver cancer only through a urine sample, to be widely used especially in resource-limited settings.

"Our research can contribute to the development of a new method of detecting liver cancer at a very early stage. This will allow the treatment and rescue of many patients, who are currently diagnosed during the later stages of diseases that cannot be treated. "Waked explains.

The Newton-Mosharafa Fund-funded research partnership helped facilitate researchers' access to advanced research facilities and laboratories that do not exist in Egypt. Waked added that the joint research project contributed to training Egyptian researchers on the use of these resources, in addition to transferring research and technical expertise to conduct high-quality research at the University of Menoufia, Egypt.

Finding immunotherapy for liver cancer

Liver cancer ranks fourth among the most common cancers in Egypt. This is due to the high prevalence of the hepatitis C virus and many other chronic liver diseases, which contribute to liver cancer. Understanding the role played by the intrahepatic immune system to find treatments for liver cancer is what Marco Zaki, a researcher at the Faculty of Pharmacy, University of Minya, Egypt, is working on through a research partnership with the University of Newcastle, UK.

The research project aims to understand the different mechanisms by which liver cancer develops in people living with different liver diseases. It focuses mainly on the roles of different immune cells that may contribute to liver cancer. This may help significantly in finding new ways to treat as well as diagnose liver cancer.

Zaki explains,  "Immunotherapy is the gold standard for treating many cancers around the world. Understanding how cancer-causing immune cells penetrate into the liver will help determine the best treatment protocols for this deadly type of cancer".

The Egyptian-British research partnership did not stop there. It extends to the establishment of a research laboratory at the University of Minya focusing on the discovery of ways to diagnose and treat liver diseases prevalent in Egypt, primarily liver cancer. Zaki believes that it will enable young researchers in Egypt to address Egypt's healthcare challenges.

Zaki also confirms that the funding provided by the Newton-Mosharafa Fund has contributed to Egyptian partnerships with leading British research institutions, enabling the exchange of experiences on the latest technologies used in health-related scientific research. Zaki is currently conducting further research on the role of immune cells in liver cancer, through a new research partnership with the Centre for Liver and Gastrointestinal Research, University of Birmingham, UK.

Liver Cancer Early Detection Diagnostic Tool 

The lack of tools and means to allow early detection of liver cancer is at the forefront of the challenges in combating the disease. Especially since no symptoms of liver cancer are shown in its early stages, though it is treatable during such stages.

This Egyptian-British research partnership aims to create a new effective, highly accurate, and low-cost method to early diagnose liver cancer, by searching for chemical compounds in patients' urine that indicate disease incidence. Such compounds can be detected by using modern techniques. This may contribute to developing a tool for early diagnosis of liver cancer, and therefore the possibility of treating it more easily and effectively.

The research team examined urine samples of people with liver diseases associated with liver cancer, such as hepatitis C, hepatic fibrosis, and cirrhosis. Their aim was to search for chemical compounds or biomarkers that can indicate liver cancer. Indeed, Al-Zahraa was able to discover several distinct metabolic compounds that could potentially be used as markers of liver cancer, and thus contribute to the development of tools for early diagnosis of the disease.

"These research efforts aim to address the dilemma of hepatitis C virus at all levels, especially infection complications leading to liver cancer. This will contribute to creating a better future for a world free of hepatitis C and its serious complications.", Al Zahraa explains.

The research project funded by the Newton-Mosharafa Fund has helped Al Zahraa, as an Egyptian researcher, advance her research and academic career. She points out that it has given her the opportunity to gain and exchange scientific experiences and skills, while at the same time trying to solve major health-related problems in Egypt, foremost of which is the burden of liver diseases.

AlZahraa Al Khatib, a researcher at the National Liver Institute at the Egyptian University of Menoufia, during her participation in a scientific conference

It is worth noting that, since its launch in 2014, the Newton-Mosharafa Fund has provided 282 scholarships to Egyptian researchers to obtain a doctoral degree, in addition to funding 69 research partnerships between Egyptian and UK universities. Research related to health care had a significant share of it, amounting to about 69%. of doctoral scholarships, and about 22% of research partnerships. This confirms the Fund's keenness to support scientific research and innovation in Egypt for affordable and inclusive health care.

The Newton-Mosharafa Fund aims to fund scientific research and innovation in five main areas: sustainable water management, renewable energy, sustainable food production, archaeology, and cultural heritage, and affordable and inclusive healthcare. These priority areas are closely related to the Sustainable Development Strategy: Egypt 2030 vision, as well as the United Nations Sustainable Development Goals.

The Newton-Mosharafa Fund is co-financed over a seven-year period by the UK Government's Department for Business, Energy and Industrial Strategy and the Egyptian Government's Ministry of Higher Education and Scientific Research. It is managed and delivered by several partners including the British Council, the British Academy in the United Kingdom, the Science and Technology Development Fund, and the Department of Cultural Affairs and Missions in Egypt.