In the developing world, it is a sad truth that the majority of people with epilepsy have no regular access to epilepsy care or antiepileptic medications. A study published in the Bulletin of the World Health Organization (Wang et al. Dec., 2008, volume 86, page 964) examined the effects of a demonstration project to deliver epilepsy care to people in five rural provinces in China. The project tried to reduce the treatment gap (untreated people with epilepsy) and morbidity by training of local health professionals, by dispelling stigma, and by integrating with existing health systems. The project was sponsored jointly by the World Health Organization and the International League Against Epilepsy. The surveyed population included 51,644 people, 320 of whom had epilepsy, yielding a lifetime prevalence of 6 per 1000 people. With the benefit of the demonstration project, the gap of untreated people dropped from 63 to 50%. This study is real-world verification of the value of bringing epilepsy care to areas that do not have it.

Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief