The Lancet Neurology's December Editorial featured the Multiple Sclerosis International Federation application to add multiple sclerosis treatments to the WHO Essential Medicines List (EML). The WHO EML Expert Committee recognised the health burden of multiple sclerosis in its review of applications in 2015 and 2019, but no medications have yet been included on the EML. Access to treatment and treatment choice are dictated by available resources, and resource allocation in many world regions is influenced by the EML. Multiple sclerosis care is guided by clinical trial evidence, country-specific regulatory approvals, and consensus guidelines. Resource-poor regions cannot afford highly priced therapeutics and available guidelines do not consider regional safety and efficacy issues that are likely to differ markedly from those in resource-rich countries. Collectively, these barriers leave many patients with multiple sclerosis overlooked therapeutically. Guidelines for multiple sclerosis management in low-resource environments are greatly needed and require direct input from regional stakeholders, driven by local champions.

中文翻译：

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多发性硬化症患者的医疗保健差距。

柳叶刀神经病学十二月的社论将“多发性硬化症国际联合会”应用程序作为特色，以将多发性硬化症治疗方法添加到WHO基本药物清单（EML）中。WHO EML专家委员会在2015年和2019年的申请审查中认识到多发性硬化症的健康负担，但EML尚未包括药物。可获得的治疗方法和治疗选择取决于可用资源，EML影响许多世界地区的资源分配。多发性硬化症的治疗以临床试验证据，特定国家/地区的法规批准和共识性指南为指导。资源匮乏的地区无法负担高价的疗法，现有指南也未考虑可能与资源丰富的国家明显不同的区域安全和功效问题。这些障碍共同使许多患有多发性硬化症的患者在治疗上被忽视。在资源匮乏的环境中，急需制定多发性硬化症治疗指南，并且需要当地利益相关者在当地倡导者的推动下直接投入。