Despite significant progress in developing effective and affordable medicines for neurological disorders, these treatments remain largely inaccessible, according to a new WHO report. The report, titled “Improving Access to Medicines for Neurological Disorders,” outlines the barriers to accessing these essential medicines and provides a framework for action.
“The impact of neurological disorders can be significantly decreased, and quality of life improved if people living with these disorders are provided access to the essential medicines they need,” said Dévora Kestel, Director of WHO’s Department of Mental Health, Brain Health, and Substance Use. “However, most people with neurological disorders struggle to access the treatment they need because these medicines do not reach them or are too expensive.”
Neurological disorders are the leading cause of disability, with over 80% of related deaths and health losses occurring in low- and middle-income countries. The treatment gap for neurological disorders, which is the difference between those who need treatment and those receiving it, exceeds 75% in most low-income countries and 50% in most middle-income countries. For example, the treatment gap for epilepsy can reach 90% in low-income countries, meaning 9 out of 10 people with epilepsy do not receive the necessary care and treatment.
Barriers to Accessing Medicines
The WHO report identifies several complex and interlinked challenges preventing access to treatment for neurological disorders, using epilepsy and Parkinson’s disease as examples:
Poor Health Financing and High Costs: High out-of-pocket expenses lead to financial hardship for individuals and their families.
Insufficient Public Awareness and Healthcare Infrastructure: Lack of awareness, inadequate infrastructure, and insufficient training for healthcare providers create barriers to diagnosis and treatment.
Regulatory and Selection Issues: The lack of appropriate selection of essential medicines at the national level and regulatory hurdles contribute to the inaccessibility of treatments.
Health Inequities: These challenges are exacerbated by existing health inequities, particularly affecting populations in low- and middle-income countries, rural areas, and other vulnerable groups, making universal health coverage difficult to achieve.
Framework for Action
The WHO report offers a comprehensive framework for stakeholders to address the barriers to accessing essential medicines for neurological disorders. The proposed actions cover multiple areas of the health system, including policy and regulatory environments, health infrastructure, and education systems. The report emphasizes the importance of engaging individuals with lived experience and fostering collaboration at various levels.
“Actions proposed in this report have clear synergies with the WHO Roadmap for access to medicines, vaccines, and other health products,” said Christophe Rerat, Senior Technical Officer in the Medicines and Health Products Division at WHO. “With the proposed approach for neurological medicines, we have a robust set of actions and a clear way forward to improve access to these essential medicines.”
Supporting Countries to Improve Access
The report is a key tool in implementing the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders (IGAP) 2022–2031, which aims to scale up access to essential medicines and technologies for managing neurological disorders by 2031.
Some countries are already making significant progress. In Ghana, epilepsy and Parkinson’s disease have been prioritized, and the national essential medicines list has been updated to include several treatments for neurological disorders. In Tanzania, a national coordination committee for epilepsy and other neurological disorders is being established to support policymakers. The country’s Medical Stores Department is making special procurements of medicines for neurological disorders, and the National Health Insurance Fund package for 2024 now includes several treatments for epilepsy and Parkinson’s disease.
These actions represent major steps toward ensuring more people with neurological disorders can access the treatment they need.
