1. Epilepsy and WHO | 17 Oct 2008 1 |1 | WHO's six-point agenda The overarching health needs 1.Promoting development 2.Fostering health security The strategic ways to meet the health needs 3.Strengthening health systems 4.Harnessing research, information and evidence How WHO can deliver 5.Enhancing partnerships 6.Improving performance

2. Epilepsy and WHO | 17 Oct 2008 2 |2 | Measuring performance Impact on: Health of the people of Africa Health of women

3. Mental health Global Action Programme: Scaling up care for mental, neurological and substance use disorders

4. Epilepsy and WHO | 17 Oct 2008 4 |4 | Strategies Identify priority conditions Develop the intervention package Identify countries for intensified support Scale up services Build partnerships

5. Epilepsy and WHO | 17 Oct 2008 5 |5 | Priority conditions Criteria High burden (mortality, morbidity, disability) Large economic cost Effective intervention available Affecting vulnerable populations

6. Epilepsy and WHO | 17 Oct 2008 6 |6 | Priority conditions in the area of mental, neurological and substance use disorders Depression Schizophrenia Suicide prevention Epilepsy Dementia Disorders due to use of alcohol Disorders due to illicit drug use Child mental disorders

7. Epilepsy and WHO | 17 Oct 2008 7 |7 | Intervention package Scope –conditions of public health priority –Individual or population based interventions to be identified on the basis of multiple criteria –Feasibility of delivery through existing health systems Target audience –Nonspecialists health care providers –Planning purposes at district level

8. Epilepsy and WHO | 17 Oct 2008 8 |8 | Intervention package Criteria for identification of interventions –Efficacy –Cost-effectiveness –Equity –Ethical issues such as protection of human rights –Feasibility and acceptability Packaging –Many interventions can be delivered by the same person at the same time –More cost-effective in terms of training, implementation and supervision

9. Intervention package Examples of interventions that can be included Evidence-based interventions Condition First line antiepileptic medicines Trained primary health professionals Referral and supervisory support Treatment with antiepileptic medicines Epilepsy Basic education about dementia Specific training on managing problem behaviours Trained primary health professionals Interventions directed towards caregivers Dementia Measures within health sector e.g. provision of skilled care at birth Public health oriented multisectoral measures e.g. food fortification with folic acid and iodine Prevention of developmental disorders Pharmacological and psychosocial interventions Child mental disorders

10. Epilepsy and WHO | 17 Oct 2008 10 | Scaling up "Deliberate effort to increase the impact of health service innovations successfully tested in pilot or experimental projects so as to benefit more people and to foster policy and programme development on a lasting basis" Innovation: set of interventions, new or perceived as new Successfully tested: interventions backed by locally generated evidence of programmatic effectiveness and feasibility Deliberate effort: guided process Policy and programme development on a lasting basis: Capacity building and sustainability

11. Epilepsy and WHO | 17 Oct 2008 11 | Cost of scaling up epilepsy care A study estimated the avertable burden of epilepsy and the population- level costs of treatment with first-line AEDs in developing countries Extension of coverage of treatment to 50% would avert 13-40% of burden The annual cost per person would be 0.20-1.33 International Dollars At a coverage rate of 80%,the treatment would avert 21-62% of the burden The cost to secure one extra healthy year of life is less than average income per person

12. Establish a plan for monitoring and evaluation Assess needs and resources Develop the intervention package Facilitate policy development Deliver the intervention package Strengthen human resources Mobilize financial resources Enhance political commitment Scaling up strategy

13. Epilepsy and WHO | 17 Oct 2008 13 | Partnerships for action WHO in partnership with: Development agencies e.g. WB Research Councils and Institutes International health agencies e.g. UNICEF Donor agencies and foundations Health communities in the countries Nongovernmental organizations Service users and caregivers

14. Epilepsy and WHO | 17 Oct 2008 14 | GCAE: a successful partnership 135 IBE/ILAE organisations in 103 different countries actively engaged Global Campaign related activities, covering 86% of the world population Two thirds of Campaign activities reported by the organisations to be either very successful or moderately successful in a recent survey Ninety percent of those surveyed said they would continue to be active in the Global Campaign in the future

15. Epilepsy and WHO | 17 Oct 2008 15 | GLOBAL CAMPAIGN AGAINST EPILEPSY Determinants of success Partnerships - involvement at every stage and level of: –ILAE, IBE, WHO –Relevant experts: epilepsy, public health –ILAE/IBE Regional Commissions and national chapters –Regional and Country Offices –Governments Ownership by all parties: political, patient, professional

16. Epilepsy and WHO | 17 Oct 2008 16 | GCAE: Future Directions Focus on: –Low and middle income countries –Africa –Further development of demonstration projects –Scaling up care –The place of GCAE in the context of WHO global and regional strategies

17. Epilepsy and WHO | 17 Oct 2008 17 | SEIN Internationaal