He is being held at the notorious Tora Maximum Security Two prison in Cairo where he has been on a hunger strike since April. Now with the COP27 climate summit underway in Sharm el-Sheik he is on a water strike.
He started to refuse water on 6 November, and last Thursday (10 November) his mother had been told by officials at Wadi al-Natroun prison that he had undergone an unspecified "medical intervention with the knowledge of a judicial authority".
However, Alaa wrote a letter to his mother dated Saturday (12 November) saying he is "drinking water again" and "receiving medical attention".
His family have said time is running out to save his life and they are urging the UK government to take action.
Prison authorities have denied his lawyer access on Thursday, Sunday and again on Monday (14 November) despite permits being granted by the prosecutor general.
The public prosecution said a medical report had shown Abdel Fattah to be in "good health", but without providing any proof.
What did he do?
The 40-year-old activist and blogger was an important figure in the pro-democracy uprising that led to the overthrow of longtime dictator President Hosni Mubarak in 2011.
Mubarak was replaced by Abdel Fattah el-Sisi, the current president, under whose rule civil society and free speech has been stifled.
Under the authoritarian rule of President al-Sisi, Alaa has spent most of the time in prison or police detention on charges that activists say are politically motivated.
In 2019, he was sentenced to a further five years in prison for allegedly spreading false news after sharing a Facebook post highlighting human rights abuses in Egyptian jails.
Earlier this month, he escalated a more than 200-day hunger strike in a bid to pressure authorities to at least allow British diplomats to visit him.
With them continuing to refuse consular access or even acknowledge his British citizenship, he wrote in a letter on 31 October that he would only drink water until COP27 opened, and then stop even doing that. His declining health has casted a shadow over the event and led to renewed calls for his release, including from Amnesty International.
British Prime Minister Rishi Sunak has raised Alaa’s case while attending COP27, calling for his urgent release at a meeting with Egyptian President Abdul Fattah al-Sisi in Sharm el-Sheikh.
US President Joe Biden, French President Emmanuel Macron, German Chancellor Olaf Scholz and UN High Commissioner for Human Rights Volker Türk have also urged Egypt to free Alaa.
Alaa has become a symbol of the 60,000 political prisoners believed by human rights groups to be languishing in Egyptian jails. Egypt insists there are none.
UK Foreign Secretary James Cleverly told the BBC’s Today programme on Monday (14 November) that he was keeping "a very, very close eye on this case".
He said: "Our officials in Egypt regularly engage with the Egyptian authorities to seek consular access so we can check on his health status. The Egyptians do not recognise him as a British citizen. We disagree with them on that and we have highlighted this disagreement to them at every level up to and including the prime minister in his discussions with President Sisi."
Abdel Fattah’s sister, Mona Seif, tweeted that the comments were "disappointing" and seemed to be "a way of shoving aside [the Foreign Office’s] responsibility towards Alaa and our family".
While former British Ambassador to Cairo John Casson accused the government of losing interest in Alaa’s case. He told Radio 4’s Today Programme: “I think things are still looking pretty grim.
“If we think where we were last week, the Prime Minister went to Egypt and said to the president of Egypt that the persecution of this British national has got to stop. In the week since it has become clear that Egypt is playing for time and banking on our ministers losing interest and being all talk.
“It looks like it might be working. Yesterday we went from the Foreign Secretary, who 12 days ago was saying he was working ‘tirelessly’ for Abdel-Fattah’s release, to yesterday saying he remained interested in the case and talking as if it’s just a procedural disagreement between friends. The Egyptians understand power and they will be smelling the weakness in what the Foreign Secretary said yesterday.”
What did Alaa say in his letter?
Sanaa Seif, the activist’s other sister, said in a tweet Monday that Egyptian prison officials sent a note to her mother saying Abd El-Fattah is alive and began drinking water again on Saturday.
Seif said the letter was “definitely” written in her brother’s handwriting.
The short letter that Abdel Fattah wrote to his mother, Laila Soueif, is dated 16:00 (14:00 GMT) on Saturday.
It says: "How are you, Mama? I’m sure you’re really worried about me. From today I’m drinking water again so you can stop worrying until you see me yourself. Vital signs today are OK. I’m measuring regularly and receiving medical attention."
Abdel Fattah promises to write a longer letter on the "day of provisions", and requests that his mother bring him an MP3 player, vitamins and effervescent salts to the prison.