EClinicalMedicine | 2019
Epilepsy in Africa: Can we end suffering and financial hardship due to lack of access to effective and affordable care?
Abstract
Article history: Received 28 March 2019 Accepted 28 March 2019 Available online 3 April 2019 in themeasures of direct cost, and differences inmethods for calculating indirect costs including not calculating them [2]. Economists will caution against using cost-of-illness studies to prioritize diseases on which to intervene or interventions to adopt. The results are at best the maximum amount that could be saved. Costeffectiveness analysis, which is the ratio of cost to health outcomes, is Some diseases, such as epilepsy, are simply neglected in the tropics, even if they aren t neglected tropical diseases. Epilepsy is amajor source of death and disability in Africa [1]. Among neurological disorders, epilepsy ranked second only to stroke for the most disability-adjustedlife-years per 100,000 people in the southern African region, and among the top five causes in the three other regions of Sub-Saharan Africa. It is also a major financial burden for people with epilepsy in Africa and their families as reported for example, in estimates of the economic burden of epilepsy in rural Democratic Republic of Congo [2]. Estimates of the economic burden, referred to by economists as cost of illness studies, are known for calling attention to a disease, because the high cost of appropriately treating an illness is newsworthy [3]. In many cases, those costs could be saved by reducing exposure to risk factors or reducing the incidence of the illness. Fodjo and colleagues report that a substantial share of household income was devoted to treating epilepsy among poor farmers [2]. Equally important, they report that the resources were devoted to inappropriate treatment. In the absence of epilepsy care at health centers, 68.2% of monetary expenditures were on traditional medicine. Inexpensive and effective drugs to treat epilepsy are essential medicines [4], and included in proposed universal health coverage packages [5]. Suffering and financial hardship due to lack of access to effective, affordable care is truly newsworthy. Three other approaches to research on costs in health economics are: cost analyses, cost-effectiveness analyses, and cost–benefit analyses. For cost-effectiveness analyses, there are widely accepted guidelines and initiatives to standardize methods and reporting to make results comparable across studies [6,7]. For global health, guidelines for cost analyseswere recently created [8], and for cost–benefit analyses are in-progress [9]. There are however, nowidely accepted guidelines or standards for cost-of-illness studies. Fodjo and colleagues demonstrated