CAIRO (AP) — Egyptian prison authorities have intervened medically with imprisoned pro-democracy activist Alaa Abdel-Fattah, who this week escalated his hunger strike and stopped drinking water, his family said Thursday, demanding his release. The drama surrounding his fate is coinciding with Egypt’s hosting of the U.N. climate summit.

With the family scrambling for details on Abdel-Fattah’s condition, officials at the prison refused to allow a lawyer for the family to visit him, despite approval by the prosecutors’ office for the visit. The laywer, Khaled Ali, said Interior Ministry officials told him the approval was not valid because it was dated Wednesday, adding in a tweet that he was only notified of the approval on Thursday morning.

The nature of the medical intervention was not known, and it was not clear if he was moved to a prison hospital. The family has expressed fears prison officials would force-feed Abdel-Fattah, which they said would amount to torture. Abdel-Fattah said in an earlier letter that he was prepared to die in prison if not freed, and Thursday was the fifth day since he said he stopped drinking water or consuming any calories.

Abdel-Fattah’s mother, Laila Soueif, has been waiting outside the Wadi el-Natroun prison complex in the desert north of Cairo every day this week, seeking proof of life of her son. She said Thursday that prison officials spoke to her outside the prison gates but refused to take a letter from her to her son.

She asked them if her son was undergoing any medical procedure and they said he was. She asked “if it was by force, and they said no” and told her, “Alaa is good,” she told The Associated Press.

“I need proof for this. I don’t trust them,” she said. The family said in a statement that its lawyers were demanding information on the substance of the “medical intervention” and that Abdel-Fattah be immediately moved to a civilian hospital.

At least 40 prisoners have died in Egyptian prisons this year, according to the al-Nadim Centre for the Rehabilitation of Victims of Violence. Among them was Alaa al-Salmi, who died in late October after being on hunger strike for several weeks.

Adam Coogle, Human Rights Watch’s deputy Middle East and North Africa director, called for Abdel-Fattah’s immediate release. He said Egyptian authorities “seem intent on imposing cruel, inhuman and degrading treatment by imposing a medical intervention against his will. Hunger striking is a political act.”

Abdel-Fattah, who has been in prison for most of the past decade, is serving a five-year sentence on charges of disseminating false news for retweeting a report in 2019 that another prisoner died in custody.

Abdel-Fattah rose to fame during the 2011 pro-democracy uprisings that swept through the Middle East, toppling Egypt’s long-time President Hosni Mubarak. His long imprisonment since 2011 became a symbol of Egypt’s sliding back to an even more autocratic rule under President Abdel-Fattah el-Sissi.

He had been on a partial hunger strike of 100 calories a day for the past six months. He stopped all calorie intake and began refusing water on Sunday, the first day of the world climate summit held at the Egyptian Red Sea resort town of Sharm el-Sheikh. Abdel-Fattah’s younger sister, Sanaa Seif, has been at the conference, aiming to increase public attention on his case.

Egypt’s hosting of the event has drawn intensified international attention to its heavy suppression of speech and political activity. Since 2013, el-Sissi’s government has cracked down on dissidents and critics, jailing thousands, virtually banning protests and monitoring social media.

At the Sharm el-Sheikh gathering, British Prime Minister Rishi Sunak, French President Emmanuel Macron and German Chancellor Olaf Scholz raised the activist’s case in their talks with el-Sissi. Abdel-Fattah gained British citizenship through his mother, who was born in London.

Speaking to the AP on Thursday at the climate conference, Egypt’s Foreign Minister Sameh Shukry declined to answer questions about Abdel-Fattah and suggested some countries were using the issue to distract from climate commitments.

“Other issues that are not directly pertaining to the climate might detract from the attention and … give justification to maybe those who would prefer to concentrate on other issues to avoid having to deal with what they need to do, how they need to implement their obligations and responsibilities,” he said.

“So, again, it is up to the parties to put the emphasis on the issues that are most important to them,” he said.