Social and economic impacts

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Epilepsy accounts for 0.5% of the global burden of disease, a time-based measure that combines years of life lost due to premature mortality and time lived in less than full health. Epilepsy has significant economic implications in terms of health-care needs, premature death and lost work productivity.

The economic impact of epilepsy varies significantly depending on the duration and severity of the condition, response to treatment, and the health-care setting. Out-of-pocket costs and productivity losses create substantial burdens on households. An economic study from India estimated that public financing for both first- and second-line therapy and other medical costs alleviates the financial burden from epilepsy and is cost-effective (1).

Although the social effects vary from country to country, the stigma and discrimination that surround epilepsy worldwide are often more difficult to overcome than the seizures themselves. People living with epilepsy can be targets of prejudice. The stigma of the disease can discourage people from seeking treatment for symptoms, so as to avoid becoming identified with the disease.

Human rights

People with epilepsy can experience reduced access to educational opportunities, a withholding of the opportunity to obtain a driving license,  barriers to enter particular occupations, and reduced access to health and life insurance. In many countries legislation reflects centuries of misunderstanding about epilepsy. For example:

  • In both China and India, epilepsy is commonly viewed as a reason for prohibiting or annulling marriages.
  • In the United Kingdom of Great Britain and Northern Ireland, laws which permitted the annulment of a marriage on the grounds of epilepsy were not amended until 1971.
  • In the United States of America, until the 1970s, it was legal to deny people with seizures access to restaurants, theatres, recreational centres and other public buildings.

Legislation based on internationally-accepted human rights standards can prevent discrimination and rights violations, improve access to health-care services, and raise the quality of life for people with epilepsy.

WHO response

WHO and its partners recognize that epilepsy is a major public health concern. WHO, the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) have led the Global Campaign Against Epilepsy to bring the disease “Out of the Shadows” to provide better information and raise awareness about epilepsy and to strengthen public and private efforts to improve care and reduce the disease’s impact.

These efforts have contributed to the prioritization of epilepsy in many countries, which resulted in regional declarations in all six WHO regions. The WHO Region of the Americas endorsed the Strategy and Plan of Action on epilepsy in 2011 and the World Health Assembly (WHA) resolution on the global burden of epilepsy (WHA68.20) was approved in 2015. The Resolution urges Member States to take coordinated action against epilepsy and its consequences.

Projects have been carried out in many countries to reduce the treatment gap and morbidity of people with epilepsy, to train and educate health professionals, to dispel stigma, to identify potential prevention strategies, and to develop models integrating epilepsy care into local health systems. Combining several innovative strategies, these projects have shown that there are simple, cost-effective ways to treat epilepsy in low-resource settings.

The WHO Programme on reducing the epilepsy treatment gap and the mental health Gap Action Programme (mhGAP) seeks to achieve these goals in Ghana, Mozambique, Myanmar and Viet Nam. These projects focus on expanding the skills of primary care and nonspecialist health providers at the community level to diagnose, treat and follow up people with epilepsy.  These four pilot programmes have led to a considerable increase in access, such that 6.5 million more people have access to treatment for epilepsy should they need it.

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