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Accurate estimates of disease burden are pivotal for driving neurological policy agendas. And yet, there are two critical dimensions of evidence that the field of neurology is still sorely missing: Unlike other NCDs like heart disease, cancers and diabetes, there is

1. a scarcity of modifiable risk factors for most neurological diseases which means that more research is badly required to catalyse effective prevention and treatment strategies
2. not enough data on the ‘amenable burden’ which refers to the burden/costs that could be avoided if people with neurological disorders and their carers were better supported, making it more possible to engage in regular activities.

The amenable burden gap is something we heard about several times when meeting with WHO – it was emphasized that it is not enough to have good data on high burden if we don’t present evidence-based solutions on how to decrease it. In simple terms, the question is: what proportion of the burden can be avoided and how can this be done?

The Economist study is providing answers to these questions and it sheds a light on why it is critical to have them answered: “understanding the amenable burden and the epidemiological burden combined can bolster the financial sustainability of neurological policy decisions, help justify investments into diagnostics and interventions, and will fill a research gap in previous studies”. As such, this can also help to make a stronger case for countries to start implementing the IGAP which is why early next year we will send a communication to European governments to inform them about the study and encourage action in the context of the IGAP.

In three parts, the Economist’s analysis seeks to provide a multi-country, multi-disorder platform to understand the importance and impact of neurological disorders. It quantifies the value of action across the most prevalent neurological disorders, showing that progress is not only achievable, but critical to meeting wider economic sustainability and resiliency goals across the globe.

Part 1 looks at:  Global variation in approaches to neurological disorders. It explores the epidemiological burden of neurological disorders worldwide, highlighting regional variations in prevalence and need.

Part 2: The costs of inaction by type of disorder assesses the economic impact of 10 neurological disorders and the return-on-investment (ROI) of scaling up access to specific care in 11 countries. For each neurological disorder, it estimates the total costs, both direct and indirect, for the following hypothetical scenarios:

• Baseline or no treatment
• Prevention – Captures the proportion of the disease burden amenable to effective public health prevention policies
• Treatment – The costs and impact associated with scaling up treatments
• Rehabilitation – The costs and impact of scaling up rehabilitation

A ROI analysis was used to explore the benefits of scaling up recommended prevention, treatment and rehabilitation interventions for select neurological disorders.

The total cost of each scenario was projected to 2030.

Additionally, part 2 explores the current policy landscape framing neurological care and delivery, discussing policy gaps and opportunities for action by country.

Out of 11 countries serving as case studies, there are several European ones included: Germany, Italy, Romania and UK. Each disorder has a general chapter which summarizes situation in addressed geographic areas, including in Europe.

Part 3: The value of action: where lies the biggest opportunity? makes global recommendations discussing the implications of the findings for the future of neurological practice. It includes useful high-level summaries for each condition called “Opportunities by type of disorder”.

The analysis also provides important insight into understanding where individuals and their caregivers are most affected by neurological disorders.

All EFNA members, and in particular those who have their diseases covered in the study, are encouraged to analyse the study and use it in its advocacy efforts. For instance, this might be exploring opportunities to submit best practices as part of DG SANTE’s Best Practice Portal or raising awareness about the amenable burden and the costs savings that the suggested interventions could bring about.

Overall, the study shows that action, particularly over time, has immense value. Therefore, “Neurological disorders must be made a national priority, through both policies and economic prioritisation, to yield the greatest benefits for both those directly affected and wider society.” We have “an opportunity to chart the path towards reducing early mortality, disability and improving quality of life more generally”.