Prioritising neurology and access for neurology patients within the context of Universal Health Coverage (UHC)

UHC represents the essential framework for delivering neurological care

From strokes to dementia, neurological conditions are the third leading cause of both disability-adjusted life years and deaths in the EU. Universal Health Coverage (UHC) represents the essential framework for delivering neurological care. A broad public health approach, grounded in principles of UHC is needed to improve the care and quality of life of those affected. The EU and its member states must remain fully engaged in UHC and take the lead in achieving UHC targets. Critical to their achievement will be meaningful engagement with people with lived experience.

In September 2023, the UN High-Level Meeting (HLM) on UHC takes place, marking a unique opportunity for advancing the prevention and control of non-communicable diseases (NCDs) such as neurological conditions.

The previous, 2019 HLM on UHC recognised that action to achieve UHC by 2030 is inadequate and that the level of progress and investment to date is insufficient to meet the Sustainable Development Goals targets. It noted that, despite major health gains over the past decades, challenges remain in areas such as NCDs, including neurological conditions. It recognised a need to scale up comprehensive and integrated services for prevention, as well as treatment for people with NCDs such as neurological conditions, noting that they are an important cause of morbidity and contribute to the NCDs burden worldwide.

Subsequently, WHO recognised that 80% of people affected by brain disorders are without any form of quality, affordable mental health care.

To bridge this gap, in 2022, the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 was adopted by WHO. The plan states that UHC represents a key component for promoting brain health and calls for addressing it in a gender-sensitive manner. It recognises that neurological conditions have strategic links to UHC, including the full range of essential health services. It is guided by people-centred UHC: all people with neurological conditions and their families should participate in and have equitable access, without discrimination or risk of financial hardship, to a broad range of promotive, preventive, diagnostic, treatment, rehabilitation, palliative and social care, as well as to essential, effective, safe, affordable and quality medicines and other health products. It calls for integrating care for neurological conditions into primary, secondary and tertiary health care levels and providing essential medicines, diagnostics, training and support for health care workers, carers and families of people with neurological conditions. One of the Plan’s global targets states that 75% of countries should include neurological disorders in the UHC benefits package by 2031.

This week, we are celebrating Brain Awareness week (13 – 19 March) which is a good opportunity to speak about the UHC and neurological care in Europe. While UHC is a well-recognised goal in the EU, unfortunately this basic right is not yet a reality for far too many European patients. The EU and its Member States have to urgently address increasing health inequalities, healthcare barriers and unmet needs faced by patients in Europe. In the area of neurological conditions, the EU and national governments should continue to fight stigma and discrimination, improve the quality of care, improve affordability of care, boost access to a full range of health services, and ensure sustainable investment in brain science and care. In doing so, the EU should fully align with the neurological global action plan.