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Peter J. Hotez 1, 2, 3 *,   Moustapha Kassem 4, 5 *

1 Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America, 2 James A. Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America, 3 Department of Biology, Baylor University, Waco, Texas, United States of America, 4 Department of Endocrinology, University Hospital of Odense, Odense, Denmark, 5 Stem Cell Unit, Department of Anatomy, King Saud University, Riyadh, Saudi Arabia

* hotez@bcm.edu (PJH); mkassem@health.edu.dk (MK).

Neglected tropical diseases (NTDs), the most common afflictions of the world’s poor, have been shown to exert important influences that extend beyond health. NTDs stifle economic development through their debilitating effects. They also stir up social stigma and cause severe psychological effects, especially for girls and women. There is an intimate link between NTDs and war or post-conflict situations, and, increasingly, with the recent emergence of Ebola and Zika, NTDs are further recognized as relevant to the global security agenda. We are still in the early stages of understanding the relationship between NTDs and such social forces, but one relationship seldom explored is the potential associations between NTDs and the arts and humanities. Possible illustrations of such a connection may be found in 20th century Egypt through the remarkable lives of Abdel Halim Hafez and Taha Hussein.

Abdel Halim Hafez (1929–1977) is ranked among Egypt’s greatest singers and artists. He was renowned and revered throughout the Arab world for his live performances and love songs. He was considered the Arabic “King of Emotions and Feelings” along with many other sobriquets, while influencing generations of singers and song writers (Fig 1) [1, 2]. Abdel Halim Hafez also gave prominently to charities, and he had a long-standing friendship with Egyptian President Gamal Abdel Nasser [2]. When Abdel Halim Hafez died in 1977 at age 48 from liver failure due to schistosomiasis caused by Schistosoma mansoni, it was said that girls and women committed suicide, including some who “jumped off balconies” at his funeral march [1, 2].

Abdel Halim Hafez grew up as an orphan, raised by an uncle and aunt who lived in extreme poverty [1, 2]. For much of the 20th century, schistosomiasis was practically ubiquitous among the poor who lived along the Nile River and its tributaries [3]. This NTD was also difficult to treat before praziquantel became available. In its place, the injectable tartar emetic was used with horrific consequences due to the fact that hepatitis C virus regularly contaminated needles used to administer the drug [4]. As a result, hepatitis C and schistosomiasis coinfections became widespread and resulted in countless deaths from liver disease and failure [4].

Abdel Halim Hafez is believed to have contracted schistosomiasis as an adolescent [1, 2], and he suffered from chronic liver disease due to the fibrosis that occurs from hepatic granulomas encasing schistosome eggs. He ultimately died from liver failure in a London hospital [2]  where he was undergoing treatment that included portosytstemicportosystemic [sic] shunt surgery in an attempt to reduce vascular pressures that resulted in esophageal varices. Attendance at his funeral may have reached millions, one of the largest ever in the Middle East and North Africa region [2]. PLOS Neglected Tropical Diseases &#124; DOI: 10.1371/journal.pntd.0005072 December 1, 2016