Working to improve access to MS treatments in low-resource settings
MSIF and the WHO Collaborating Centre Bologna’s application to add Multiple Sclerosis treatments to the World Health Organization’s Essential Medicines List (EML) is now publicly available on the WHO website. The EML has a key role in improving access to medicines globally, as a tool for awareness-raising and advocacy. If this application is successful, it will formally acknowledge MS as a global health concern and put it higher on the agenda of the WHO and individual countries. As an action that has the potential to improve access to treatment for MS and contribute to relieving the burden of neurological diseases, the EAN officially endorses this application.
In December 2022, MSIF applied to add MS treatments to the World Health Organization’s Essential Medicines List (EML) together with the WHO Collaborating Centre Bologna. This was the result of many years of effort from MS experts across the globe, who undertook a rigorous review of all the disease-modifying therapies (DMTs) for MS to develop recommendations for the application.
Why did MSIF carry out this project?
There is unequal access to MS treatments across the world. Twenty different DMTs have been approved by the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) for MS as of 2022. Yet access to DMTs is not universal. Access to MS treatment is subject to a country’s healthcare system and whether someone can pay for services. The Atlas of MS shows that in 70% of countries people with MS face barriers in accessing DMTs, and around half of countries say a major barrier is the cost to the individual, government, healthcare system or insurance provider.
It is vital for people with MS to get the right treatment at the right time. That’s why MSIF and the WHO Collaborating Centre Bologna applied for MS DMTs to be added to the WHO EML.
Sanae from Morocco speaks about the financial challenges she faces when trying to access MS healthcare.
‘To even get my diagnosis I had to borrow money from others. I did not have enough money to get treatment. I was devastated. I saw my whole career diminishing. The financial resources did not exist to support it.’
What is the WHO Essential Medicines List and why is it important?
The WHO Essential Medicines List (EML) has a key role in improving access to medicines globally. Essential medicines are those that are needed as a minimum to satisfy the priority healthcare needs of a population. There are currently no treatments for MS on the WHO EML.
Listing MS DMTs on the WHO EML creates a tool for awareness-raising and advocacy. It is a WHO-level stamp of approval, moving the conversation from whether MS DMTs should be made available to how to make them available in low-resource settings. Importantly, the listing of any MS DMTs on the WHO EML will formally acknowledge MS as a global health concern and put it higher on the agenda of the WHO and individual countries.
How can I learn more about the application?
MSIF first applied to add MS treatments to the WHO EML in 2018, but this application was not successful. However, the WHO Expert Committee acknowledged the global public health burden of MS and encouraged a revised application. You can read about the 2018 application process here.
In 2020, MSIF, in collaboration with the WHO Collaborating Centre Bologna, started developing a new application with the help of two independent panels: the MSIF Off-Label Treatments panel (MOLT) and MSIF Essential Medicines Panel (MEMP). Both panels were independent, multi-disciplinary, and had international representation. Importantly, the panels included people affected by MS from Uruguay, Serbia, Namibia and Morocco. They also partnered with the Cochrane MS group and McMaster GRADE Centre during this process, both groups being internationally regarded as experts in the field of evidence reviews and decision-making. You can read more about the current application here, and access the full text from the WHO website. If you have any questions about this EML application, please read the MSIF’s FAQs or email Joanna@msif.org.
What happens next?
The WHO EML Expert Committee will meet 24-28 April 2023 to assess all the applications, and an outcome is expected by June 2023.
Applying to add DMTs to the WHO EML is only one route to improving access to MS treatments. MSIF will continue working to gain access to affordable treatment for everyone, especially in low-resource settings. You can learn more about MSIF’s work here.