Availability and affordability of therapies and services of multiple sclerosis in Africa: A continent-wide survey

BACKGROUND: Limited data is available about the availability of multiple sclerosis (MS) therapies and services in Africa. OBJECTIVE: We aimed to investigate the availability, affordability, frequency of usage, and insurance coverage of MS therapies and services across Africa. METHODS: A comprehensive web-based survey was constructed and distributed to neurologists from different African countries. The survey addresses availability, affordability, frequency of use, and insurance coverage of different therapies and services of MS. RESULTS: Respondents represented 27 African countries. Intravenous methylprednisolone was always available in most countries (88.9%), while interferons were completely or partially available in 13 countries (48.1%). The most available disease-modifying therapies (DMTs) were rituximab (22 countries, 81%), followed by interferon beta 1a intramuscular type (12, 44.4%). Availability of other DMTs was variable, while specific MS services were limited. Affordability is limited in most countries, and the use of DMTs was related to insurance coverage. Most associated therapies and investigations were more available and affordable, but less insured. Neurologists were the main healthcare providers, but traditional healers had a role in 14.8% of countries. CONCLUSION: Significant challenges characterize MS care in Africa. MS therapies, particularly DMTs and services, are inaccessible and unaffordable in most African countries.