The Atlas of MS shows that access to disease-modifying treatments for MS (DMTs) is challenging in over 70% of countries across the world. Early access to high-efficacy treatment is essential to slow the progress of the disease and improve long-term quality of life for people with MS. A new study, published in the journal Multiple Sclerosis and Related Disorders, explores the situation in Southeast Asia and the specific factors that influence availability and affordability of DMTs:

The Southeast Asia (SEA) region comprises 11 countries, with a population of 600 million. Countries have different economic and healthcare systems, mostly low and middle income backgrounds. Currently, there is a lack of focus on MS, as it is viewed as a rare disease, and access to DMTs is challenging even in the region’s high- and upper-middle income countries.

To develop strategies to improve MS management in the region, it is important to first understand all the factors that influence access to treatment, and how they interact with each other. These include the availability of medicines, health financing, human resources, health information, infrastructure, service delivery and the relation of all of these to society and governance.

In this recent publication, a survey was conducted with 15 neurologists from all 11 countries. The survey aimed to find out:

  1. “How is access to DMTs (on-label and off-label) sought, organised, financed and used within SEA countries?” and
  2. “What are the barriers and challenges to MS management in SEA?”.

The data collected showed there is variation between individual countries, but across the region the biggest challenges that prevent optimal access to treatment are:

  • A lack of MS specialist neurologists, MS nurses and specialist training.
  • Difficulty accessing biomarker testing for diagnosis.
  • Lack of registries and data on prevalence/incidence of MS.
  • Limited or no financial coverage for DMTs – many people with MS have to pay for some or all of their treatment.
  • Most countries lack MS organisations or have limited capacity for advocacy.

Dr Shanthi Viswanathan and Dr Lim Su Yin, who led the study, say:

“Neurologists in Southeast Asia are clear that access to MS treatment is a fundamental human right. We as a community call for more action at the systemic, regional and national level to address the barriers we have identified in this study. This includes procuring generic options, discussing price negotiations and clinical trial participation with pharmaceutical companies, increasing patient advocacy and education or training programmes.

Furthermore, with the recent inclusion of a number of MS drugs on the WHO Essential Medicines List, regional adoption that is adapted to the local setting will go a long way in improving sustainable access to treatment. This call for action is timely, as evidence suggests MS is a neglected non communicable disease in our region and patients with MS cannot wait any longer to be treated. Lets act now to help all people affected by MS.”

For further details, access the full publication here: Multi-actor system dynamics in access to disease-modifying treatments for multiple sclerosis in Southeast Asia: A regional survey and suggestions for improvement

This research was inspired by the Atlas of MS, and the lack of data on access to treatment in the Southeast Asia region.

Find out more about how access to MS healthcare varies around the world in our Clinical Management report, and access data about your own country through the Atlas of MS website.

Data from the Atlas of MS is freely available to everyone. If you are interested in analysing data on a particular topic or specific to your region, then we encourage you to do so. Please get in touch with Rachel or Anne at if you’d like to discuss your ideas.

Visit our access and advocacy website for more information about improving access to treatment.