World Health Organization developing new global action plan for epilepsy and other neurological disorders

The World Health Organization (WHO) is in the process of developing an “Intersectional global action plan on epilepsy and other neurological disorders” following the decision of the 73rd World Health Assembly. In this article, Stéfanie Fréel and Katrin Seeher of the WHO explain what this means for dementia policy.

Stéfanie Fréel

Katrin Seeher

Background

In adults, neurological disorders are the leading cause of disability-adjusted-life years (11.6% of DALYs) and the second leading cause of death (9 million deaths per year). The largest contributors of global neurological DALYs in 2016 included stroke (42.2%), migraine (16.3%), dementia (10.4%), meningitis (7.9%) and epilepsy (5%). As of 2016, 52.9 million children younger than 5 years had developmental disabilities, the majority living in low- and middle-income countries (LMICs).

As is the case for dementia, access to services and support including to diagnosis, treatment and essential cost-effective medicines, for neurological disorders is insufficient, particularly in LMICs. For example, 1 in 10 people with dementia receive a diagnosis, while only 1 in 4 people with epilepsy receive treatment. There also continues to be a lack of knowledge around neurological disorders, which in many countries is associated with high stigmatisation and discrimination. Dementia and other neurological disorders are associated with a significantly increased risk of mortality in patients with COVID-19 and are the second most common comorbidities in patients with COVID-19.

Multilateral response

To address the growing burden of neurological disorders, a meeting of the 146th Executive Board in February 2020, requested the World Health Organization (WHO) to expand the scope of its technical report on epilepsy by adding a new section on Synergies in addressing the burden of epilepsy and other neurologic diseases. This section was presented as part of agenda item 11.6 on epilepsy during the Seventy-third World Health Assembly (WHA) in May 2020. Resolution WHA 73.10 requests the Director-General to develop an Intersectoral global action plan on epilepsy and other neurological disorders 2021–2031 in consultation with Member States to ensure a comprehensive, coordinated response across multiple sectors.

To support the development of the new action plan, WHO – through its Brain Health Unit – organised formal virtual consultations on the discussion paper for the Intersectoral global

action plan on epilepsy and other neurological disorders with Member States, United Nations agencies, and non-State actors including academic institutions, civil society and private sector in March and April 2021. The draft Intersectoral global action plan on epilepsy and other neurological disorders will be submitted to the 150th session of WHO’s Executive Board in January 2022, for consideration by Member States at the 75th World Health Assembly in May 2022.

Alignment with the Global action plan on the public health response to dementia 2017–2025

Through its life-course approach, the Intersectoral global action plan on epilepsy and other neurological disorders will help reinforce dementia as a global public health priority, within the broader context of neurological disorders. It will present many synergies with the Global action plan on the public health response to dementia 2017–2025, its seven action areas and cross-cutting principles. This includes for example promotion of healthy behaviours across the life course, integrated, person-centred approach to evidence-based prevention, diagnosis, treatment and care, and focus on investment into research, innovation and health information systems.

Similar to the global dementia action plan, the Intersectoral global action plan on epilepsy and other neurological disorders will seek to prioritise neurological disorders within national policy agendas, harmonise a comprehensive response across health and social care systems and stakeholders, and ensure sustainable funding to support programming for people living with neurological disorders, their families and carers. A strong focus will also be set on gender, equity and human rights, including to reduce stigma and discrimination, and empowering people with neurological disorders, their families and carers. The intersectoral global action plan on epilepsy and other neurological disorders will share many strategic interlinkages with the global action plan on dementia, including its alignment with the United Nations Political Declaration on Universal Health Coverage (2019), the Declaration of Astana on Primary Health Care (2018), the Comprehensive mental health action plan (2013–2020), the Global action plan for the prevention and control of noncommunicable diseases 2013–2020, the United Nations Decade of Healthy Ageing (2021–2030) and many other resolutions, decisions and declarations.

These intersections will maintain and raise dementia as a key public health priority on national political agendas, ensuring that people with dementia, their families and carers are treated with equality and dignity, receive the treatment and care they need, and enjoy the highest quality of life at home in their communities.