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Indian children with epilepsy do not have access to specific services, says report
POLICY AND PEOPLE
US-led health programme breaks down boundaries in Middle East emphasised the need for haste. “Patients who manage to escape the closure and get to Jordan do so privately and need financial help.”
Rights were not granted to include this image in electronic media. Please refer to the printed journal. AP
he Middle East Cancer Consortium (MECC) Ministerial Steering Committee, chaired by US Secretary of Health and Human Services Tommy Thompson, has voted in favour of setting up a patient care mission, starting with radiotherapy services for patients living in Palestine. There is “an urgent need for the 400 patients who need radiotherapy every year”, said Munzer Sharif, the Palestinian Deputy Minister of Health, who added that he was “very pleased to hear about the initiative”. To date, Palestinian patients have been referred to Israeli and Jordanian treatment facilities, but the security closures and the accumulated debts for previous treatment—some US$10 million to Israeli hospitals —have all but prevented any new patients receiving therapy, said Sharif. MECC’s Executive Director Michael Silbermann said “this is a two-step action, first to assure immediate access in the region, in Jordan, Israel, or Cyprus, for patients in need of treatment; and simultaneously to plan for two radiotherapy centres and faculty training, for the West Bank and Gaza”. Faleh Al-Nasser, the Jordanian Minister of Health and Health Care,
T
Tommy Thompson
Joe Harford, the associate director for special activities at the National Cancer Institute (NCI; Bethesda, MD, USA), who had assisted in the birth of MECC under former NCI director Richard Klausner, endorsed Al-Nasser’s suggestion, providing “the numbers can be worked out”. MECC’s success seems to have had a great effect on the Middle East medical community. The newly appointed chief scientist of the Israel Health Ministry, Rami Rahamimoff (Hebrew University of Jerusalem)—who serves on the MECC Board of
Governors—has recommended creating a new Middle East Health Consortium using MECC as “model for productive cooperation”. The new initiative would “reach well beyond cancer” and “involve other NIH [National Institutes of Health] institutes to make this outreach truly comprehensive and beneficial to all people in the region”. Rahamimoff suggested that the crossborder health programme should first tackle infectious diseases, child health, and mental-health conditions. Thompson has expressed his enthusiasm for the proposals. While Frixos Saviddes, Cypriot Minister of Health, summed up the feeling among MECC’s members that “were the US to lead the effort, it would be a great inspiration and assistance to the area”. Thompson has proposed to lead a delegation of experts from the US NIH and other US government agencies that would meet for a 1-day planning session to convene in the Middle East, to examine “feasibility and how to implement the plan”, adding that “we need a bigger vision” and “a readiness to take a very positive role in developing good care for the region”. Rachelle HB Fishman
Indian children with epilepsy do not have access to specific services, says report
T
he epilepsy treatment infrastructure in India is inadequate and the lack of coverage is “the number one problem” for tackling this neuropsychiatric disorder, which costs India US$1·7 billion per year, according to a discussion paper sponsored by the UK government’s Department for International Development. Prejudice against people with epilepsy still persists despite recent lifting of discriminatory legislature in India. But despite this breakthrough, the report calls on pressure groups and others to mobilise, raise awareness, and influence national and local policy makers to improve conditions for people with epilepsy in India. 50-60 million people worldwide have epilepsy and almost 10 million of this number live in India. Costeffective antiepileptic drugs are available in developed nations; however almost 95% of patients worldwide with active epilepsy don’t have access to any interventions.
2094
The report, by Deb Pal, a paediatric neurologist from Columbia University (New York, NY, USA), drew on original research, systematic reviews, and face-to-face interviews with families and service providers across India. The report looked at the scale of the public health problem posed by childhood epilepsy in India. Most children with epilepsy in India do not have access to specific epilepsy services, the report said, and if no drug treatment is available then “social interventions may alleviate disability and improve quality of life not only for the affected child but for the rest of the family”. One of the main hurdles to delivering effective and comprehensive epilepsy services is the state of the current health service infrastructure, the report found. “Services for chronic diseases, like epilepsy, highlight the present deficiencies across all sectors in regards to capacity for long-term follow-up, attention to functional
disability, and losses to the economy”, said Pal. Creative partnerships with other sectors could fill some of the access gaps, he added. India does have some “worldclass” specialist urban treatment centres, some of which have outreach treatment programmes. However, the report noted that most of these centres are not community orientated and are not a viable model for expanding treatment coverage. Government services are inadequate and are “orientated towards bureaucracy and poorly managed”, the report said. “The government can play a stronger role in removing proposed user charges for chronic diseases, in promoting positive attitudes and social integration for people with epilepsy, and ensuring that the availability of low-cost drugs is not threatened by future international trade agreements”, Pal told The Lancet. Haroon Ashraf
THE LANCET • Vol 359 • June 15, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.
US-led health programme breaks down boundaries in Middle East emphasised the need for haste. “Patients who manage to escape the closure and get to Jordan do so privately and need financial help.”
Rights were not granted to include this image in electronic media. Please refer to the printed journal. AP
he Middle East Cancer Consortium (MECC) Ministerial Steering Committee, chaired by US Secretary of Health and Human Services Tommy Thompson, has voted in favour of setting up a patient care mission, starting with radiotherapy services for patients living in Palestine. There is “an urgent need for the 400 patients who need radiotherapy every year”, said Munzer Sharif, the Palestinian Deputy Minister of Health, who added that he was “very pleased to hear about the initiative”. To date, Palestinian patients have been referred to Israeli and Jordanian treatment facilities, but the security closures and the accumulated debts for previous treatment—some US$10 million to Israeli hospitals —have all but prevented any new patients receiving therapy, said Sharif. MECC’s Executive Director Michael Silbermann said “this is a two-step action, first to assure immediate access in the region, in Jordan, Israel, or Cyprus, for patients in need of treatment; and simultaneously to plan for two radiotherapy centres and faculty training, for the West Bank and Gaza”. Faleh Al-Nasser, the Jordanian Minister of Health and Health Care,
T
Tommy Thompson
Joe Harford, the associate director for special activities at the National Cancer Institute (NCI; Bethesda, MD, USA), who had assisted in the birth of MECC under former NCI director Richard Klausner, endorsed Al-Nasser’s suggestion, providing “the numbers can be worked out”. MECC’s success seems to have had a great effect on the Middle East medical community. The newly appointed chief scientist of the Israel Health Ministry, Rami Rahamimoff (Hebrew University of Jerusalem)—who serves on the MECC Board of
Governors—has recommended creating a new Middle East Health Consortium using MECC as “model for productive cooperation”. The new initiative would “reach well beyond cancer” and “involve other NIH [National Institutes of Health] institutes to make this outreach truly comprehensive and beneficial to all people in the region”. Rahamimoff suggested that the crossborder health programme should first tackle infectious diseases, child health, and mental-health conditions. Thompson has expressed his enthusiasm for the proposals. While Frixos Saviddes, Cypriot Minister of Health, summed up the feeling among MECC’s members that “were the US to lead the effort, it would be a great inspiration and assistance to the area”. Thompson has proposed to lead a delegation of experts from the US NIH and other US government agencies that would meet for a 1-day planning session to convene in the Middle East, to examine “feasibility and how to implement the plan”, adding that “we need a bigger vision” and “a readiness to take a very positive role in developing good care for the region”. Rachelle HB Fishman
Indian children with epilepsy do not have access to specific services, says report
T
he epilepsy treatment infrastructure in India is inadequate and the lack of coverage is “the number one problem” for tackling this neuropsychiatric disorder, which costs India US$1·7 billion per year, according to a discussion paper sponsored by the UK government’s Department for International Development. Prejudice against people with epilepsy still persists despite recent lifting of discriminatory legislature in India. But despite this breakthrough, the report calls on pressure groups and others to mobilise, raise awareness, and influence national and local policy makers to improve conditions for people with epilepsy in India. 50-60 million people worldwide have epilepsy and almost 10 million of this number live in India. Costeffective antiepileptic drugs are available in developed nations; however almost 95% of patients worldwide with active epilepsy don’t have access to any interventions.
2094
The report, by Deb Pal, a paediatric neurologist from Columbia University (New York, NY, USA), drew on original research, systematic reviews, and face-to-face interviews with families and service providers across India. The report looked at the scale of the public health problem posed by childhood epilepsy in India. Most children with epilepsy in India do not have access to specific epilepsy services, the report said, and if no drug treatment is available then “social interventions may alleviate disability and improve quality of life not only for the affected child but for the rest of the family”. One of the main hurdles to delivering effective and comprehensive epilepsy services is the state of the current health service infrastructure, the report found. “Services for chronic diseases, like epilepsy, highlight the present deficiencies across all sectors in regards to capacity for long-term follow-up, attention to functional
disability, and losses to the economy”, said Pal. Creative partnerships with other sectors could fill some of the access gaps, he added. India does have some “worldclass” specialist urban treatment centres, some of which have outreach treatment programmes. However, the report noted that most of these centres are not community orientated and are not a viable model for expanding treatment coverage. Government services are inadequate and are “orientated towards bureaucracy and poorly managed”, the report said. “The government can play a stronger role in removing proposed user charges for chronic diseases, in promoting positive attitudes and social integration for people with epilepsy, and ensuring that the availability of low-cost drugs is not threatened by future international trade agreements”, Pal told The Lancet. Haroon Ashraf
THE LANCET • Vol 359 • June 15, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet Publishing Group.