Access to MS treatments

We believe MS is a global health concern. That’s why we are advocating for the addition of MS treatments to the World Health Organization’s Essential Medicines List.

Unequal access to MS treatments

Very effective treatments, or disease modifying therapies (DMTs), exist to manage MS. DMTs aren’t a cure for MS but they can reduce relapses and future disability. MS is a complex disease, so it’s important to have a range of DMTs available for people with MS to consider the benefits and risks of different approaches.

20 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. Accessing the right MS treatment depends on whether:

  • people have access to healthcare
  • the healthcare system will pay for MS care (e.g. diagnosis and treatment)
  • a range of DMTs are available and covered by the healthcare system
  • there is a continuous and reliable provision of treatment.

It is vital for people with MS to get the right treatment at the right time. That’s why we want MS DMTs to be added to the WHO Essential Medicines List (EML).

Sanae and her daughter outside their home in Fes, Morocco.

Sanae and her daughter outside their home in Fes, Morocco.

Sanae from Morocco faces financial challenges when she tries 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.”

The WHO Essential Medicines List

The World Health Organisation’s Essential Medicines List (EML) has a key role in improving access to medicines globally. Essential medicines are those that that are needed as a minimum to satisfy the priority health care needs of a population. The WHO EML is revised every two years by a committee of global experts, and used as a guide by many countries around the world to prioritise medicines.

The WHO EML currently lists no MS treatments, and very few medicines for neurological conditions. Listing MS DMTs on the WHO EML creates a tool for awareness-raising and advocacy regardless of whether a country has an effective national EML or not. 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. MSIF is working to make this happen, to empower national action to improve access to MS treatments around the world.

Our first application to the EML

In 2018 MSIF applied to add three MS DMTs to the WHO EML, but these treatments were not added to the list. The WHO Expert Committee acknowledged the public health burden of MS, the need for effective and affordable MS medications, and the high volume of letters received in support, but requested a revised application. You can read about the 2018 application process here.

Current application to the EML

MSIF, in collaboration with the WHO Collaborating Centre Bologna, has developed 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 are independent, multi-disciplinary and have international representation. Importantly, the panels included people affected by MS from Uruguay, Serbia, Namibia and Morocco. We 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 find links to the Cochrane reviews underpinning the work on their website.

The panels were tasked with reviewing DMTs for MS: all DMTs that have regulatory approval, as well as some DMTs that are used ‘off-label’. The panels considered DMTs for relapsing and progressive MS, and also took into account the needs of special populations, including adolescents, and pregnant or breast-feeding women.

Our application to the WHO EML is publicly available on the WHO website as of 9 February 2023. Open comment will be possible until Friday 8 April 2023, 18h00 CEST. The WHO EML Expert Committee will meet 24-28 April 2023 to assess all the applications, and we expect to be informed of the outcome by June 2023.

The Lancet Neurology highlights MSIF’s application in their March Editorial

‘Approval by WHO of the MSIF application will be a crucial first step to ensure that people with multiple sclerosis will be able to access appropriate treatment options in LMICs’

Read the editorial here.

Fifteen organisations endorsed the application:


Find answers to the most frequently asked questions about our application to add MS treatments to the WHO EML.

Learn more about MSIF’s work on access to MS healthcare

Applying to add DMTs to the WHO EML is only one route of improving access to MS treatments. MSIF will continue working to gain access to safe, effective and affordable treatment for everyone, especially in low-resource settings. You can learn more about our work here.