Quantifying the global impact of neurological conditions: a first step in addressing the challenge and need for action

Neurological conditions are the leading cause of disability, and the second leading cause of death worldwide. Over the last 30 years, there has been a 40% increase in the number of deaths due to neurological diseases. As global populations continue to grow and age, the impact is set to increase. Although these statistics give us an idea of the impact of neurological conditions, the unfortunate truth about the burden of these conditions globally, is that it is largely unknown. The Global Burden of Disease (GBD) provided estimates of prevalence, however additional data collection is often inconsistent and varies from one country to another.

Without robust and comprehensive data to drive progress forward, there are limits to meet the UN sustainable development goals targets (SDG) to reduce one-third of premature mortality from non-communicable diseases, such as neurological conditions, through prevention and treatment by 2030. We have seen that COVID-19 has caused a huge shift in focus towards infectious diseases, but considering the impact of neurological conditions, it is hard to comprehend why they are not a higher priority for health systems across the world. Only a handful of countries have adopted national strategies for accelerating brain research across Europe. The importance of innovation and establishing effective policies to enhance the management of neurological conditions is undeniable and is needed to help achieve the SDG target.?

To quantify the value of innovation, and to understand where policies are most needed, we need a clear understanding of the direct and indirect impacts of neurological conditions. To inform this, we worked with Economist Impact to generate a report entitled The Value of Action: Mitigating the Global Impact of Neurological Disorders. Recognising the impact of neurological conditions across different countries and how subsequent actions will differ based on the conditions, the research took a multi-country, multi-condition approach. The current epidemiological and economic impact, the current policy landscape and the value of action were evaluated in 10 of the most common neurological conditions across 11 countries.?

Published this week, I have had the opportunity to read the report and reflect on where we must focus innovation and policies to ensure that no patient, and no caregiver, is left behind.

1. Adopt a global response. From the data we do have, we know that 70% of people living with neurological conditions live in low- and middle-income countries (LMICs). However, these conditions are poorly recognised by governments. In fact, only 28% of LMICs have a dedicated neurological policy which refers to specific plans or actions outlined by governments to manage neurological conditions. Public health expenditure is low from a global perspective, with only 12% of all countries in the WHOs Neurology Atlas reporting a separate budget for neurological conditions. It is clear that a global response is required to make significant changes, but it is essential that this response is tailored to have national impact.??
2. Tackle stigma and discrimination. From concealment of symptoms to the capability of healthcare professionals to provide care, individual and societal stigma acts as a barrier to diagnosis, early intervention and management of neurological conditions. To create a groundswell of demand for innovation, and for policies to have an impact, tackling stigma is foundational. While we must all take the time to challenge our own perceptions around neurological conditions, societal action is required. Policymakers can draw inspiration from Japan who recently created a Framework for Promoting Dementia Care. As part of this strategy, ministries are required to drive awareness of cognitive impairment across society, from bankers and police to taxi-drivers and retailers, to help normalise and create barrier-free spaces and services for people with dementia.
3. Establish policies that drive prioritisation of rare neurological conditions. Collectively, neurological conditions impact millions of people worldwide, yet some conditions, such as spinal muscular atrophy (SMA), are less prevalent and are recognised as rare diseases. However, despite the prevalence of rare diseases being low, the impact on individuals and their families can be disproportionately high. To truly mitigate the impact of these conditions, policies must be put in place that accommodate all neurological conditions. Over the past few years, we have seen some promising approvals in treatments for SMA, and positively, a number of countries have announced reimbursement policies to facilitate wider access. However, due to varying pressures between national health systems, reimbursement may not be feasible for all countries, and so policies must be put in place to support cross-border access to treatments. In doing so, we can ensure that where a patient lives does not dictate whether they receive treatment. But access to treatment is just one challenge for people living with SMA and their families – policies must go further. For many, expensive specialist mobility equipment is required, but in several countries financial support is limited. Even in countries where financial support is available, such as Germany, Italy, Romania and the UK, it varies in its availability and access remains unequal. ?
4. Expand the use of telemedicine across neurological conditions. Whilst innovation must support research and development into new treatments for neurological conditions, it must also help us advance the ways in which we monitor and manage patients. The COVID-19 pandemic has resulted in a rapid adoption of the provision of telemedicine, and now we should look to embrace this technology in neurological conditions. Telemedicine represents a powerful tool across the care continuum, by facilitating access to care despite geographies, availability of specialist centres, or disabilities. A wider adoption of telemedicine can help avoid delays between onset of symptoms, diagnosis and treatment, reduce productivity costs and support consistent monitoring of progression.

The Economist Impact report shows that mitigating the impact of neurological conditions is a significant challenge, and it is clear that no one group can overcome this challenge alone. So, what’s next? I firmly believe that for innovation and access to be successful, a collaborative approach is essential. As a company, we have committed to a journey of discovery that involves collaborating with equally passionate organisations, who can bring a unique set of expertise and perspectives to the table.