Housing policy and finance in Egypt: extending the reach of mortgage credit

This thesis attempts to address the need for a clear strategy for the supply side in the Egyptian mortgage market. The thesis focuses for the first time on the issues in relation to the role of the bank and non-bank financial institutions in the creation of an effective and sustainable mortgage market that works better for low- and moderate-income households in Egypt as well as the role of these institutions after the mortgage market has reached a certain stage of development. The key research objectives are as follows: 1) to address why Egyptian housing co-operative societies can be seen as important policy agents to expand the mortgage credit beneficiaries base in Egypt; 2) to evaluate the effectiveness of the Egyptian housing co-operative societies as community based organisations and policy agents; 3) to identify and analyse the various economic, social and political factors influencing this effectiveness; 4) to assess the role of the banking institutions (as contextual stakeholders in the immediate environment of the Egyptian housing co-operative societies) in expanding access to mortgage credit and savings in Egypt; and 5) to identify which institutions constrain most the development of an effective and sustainable level of mortgage credit for low- and moderate-income households. In order to address these issues and objectives, the researcher reviewed the theoretical and empirical issues associated with the assessment of mortgage credit intermediation models to identify their reach and the limit of that reach and, implicitly, to examine what needs to be done to close the gap on what would be a more accessible mortgage market. Further, from 2008 to 2010, the researcher surveyed and interviewed a group of banking, co-operative and government officers in Cairo, Egypt. Questions regarding their attitudes towards housing policy and finance in Egypt were posed, especially in relation to the provision of mortgage credit in Egypt. The thesis found that Egyptian banking institutions, as agents in carrying out housing policies and finance, enabled the housing co-operative societies as stakeholders to form expectations towards the results of the new reforms with the same framework as they had done before. The survey and interviews showed that housing co-operative societies were dissatisfied with the expected results of recent reforms in the Egyptian housing and mortgage markets. It appears that resistance to the reforms was caused by the fact that housing co-operative societies were not interested. But the thesis found that the unfair distributive results associated with mortgage credit allocation were resented most by housing co-operative societies. Thus, the thesis concludes that to extend the reach of mortgage credit, there needs to be a wider strategy to reform the housing and mortgage markets in Egypt that includes strengthening the role of community institutions such as Egyptian housing co-operative societies based on well defined and structured stakeholder framework

Symptomatic Acute Hepatitis C in Egypt: Diagnosis, Spontaneous Viral Clearance, and Delayed Treatment with 12 Weeks of Pegylated Interferon Alfa-2a

The aim of this study was to estimate the proportion of spontaneous viral clearance (SVC) after symptomatic acute hepatitis C and to evaluate the efficacy of 12 weeks of pegylated interferon alfa-2a in patients who did not clear the virus spontaneously.Patients with symptomatic acute hepatitis C were recruited from two "fever hospitals" in Cairo, Egypt. Patients still viremic three months after the onset of symptoms were considered for treatment with 12 weeks of pegylated interferon alfa-2a (180 microg/week).Between May 2002 and February 2006, 2243 adult patients with acute hepatitis were enrolled in the study. The SVC rate among 117 patients with acute hepatitis C was 33.8% (95%CI [25.9%-43.2%]) at three months and 41.5% (95%CI [33.0%-51.2%]) at six months. The sustained virological response (SVR) rate among the 17 patients who started treatment 4-6 months after onset of symptoms was 15/17 = 88.2% (95%CI [63.6%-98.5%]).Spontaneous viral clearance was high (41.5% six months after the onset of symptoms) in this population with symptomatic acute hepatitis C. Allowing time for spontaneous clearance should be considered before treatment is initiated for symptomatic acute hepatitis C