FAST (Fight Against STigma) Program

Mental Health & Epilepsy: Tackling the challenge of access to care

Tackling the Challenge of Access to Mental Health and Epilepsy Care in Low- and Middle-Income Countries

In low- and middle-income countries (LMICs), insufficient specialized human resources, inadequate training of primary care workers, traditional beliefs, stigmatization and discrimination are the most common barriers to access to care for people with mental or neurological disorders. Availability and cost of medicines are also common issues. It is estimated that 80% of patients with mental disorders or epilepsy living in LMICs are not treated. (1,2)

In 2008, the World Association of Social Psychiatry (WASP) joined forces with Sanofi Global Health and the Institute of Epidemiology and Tropical Neurology (IENT, UMR 1094 Inserm) to promote access to healthcare for patients with mental disorders or epilepsy in LMICs.

Through the Fight Against STigma (FAST) program, and associated projects, initiatives have been launched in over 20 countries in Africa, Asia, South America, and Eurasia. (3-12)

Developed with local health authorities, local experts and health professionals, patient associations or NGOs, these projects are based on training health workers, raising public awareness, educating patients and their families. Thanks to these initiatives, it is estimated that over 10,600 healthcare workers have been trained, over 3.18 million people have been reached through awareness and educational activities, and over 132,000 people with mental illness or epilepsy have been diagnosed and/or treated. (13)


1. World Health Organization, Media Centre, Mental Disorders Fact sheet, 9 April 2018.
2. World Health Organization, Media Centre, Epilepsy Fact sheet, 7 February 2019.
3. Khin Maung Gyee. A letter from Yangon, Myanmar. Lancet Psychiatry, 2019; 6 (1):99.
4. Boumédiène F., Chhour C., Chivorakoun P., Souvong V., Odermatt P., Ros S. et al. Development of an interventional strategy for the management of epilepsy in South-East Asia. XXIII World Congress of neurology, Sep 2017, Kyoto, Japan.
5. Tekle-Haimanot R., Preux P-M., Gerard D., Worku D.K., Belay H.D., Gebrewold M.A. Impact of an educational comic book on epilepsy-related knowledge, awareness, and attitudes among school children in Ethiopia. Epilepsy & Behavior. 2016; 61: 218–223.
6. Gaglione J.M. Mali: developing a community mental health network in rural areas. 19th WPA World Congress of Psychiatry – August 2019.
7Aghekyan E. Improving access to care for people with schizophrenia and/or depression in Armenia. 19th WPA World Congress of Psychiatry – August 2019.
8. Paiz A. ALAS Pro Salud Mental: improving access to mental health care in rural Guatemala. 19th WPA World Congress of Psychiatry – August 2019.
9. Giuliano L, Cicero C.E., Padilla S., Rojo Mayaregua D., Camargo Villarreal W.M., Sofia V. et al.. Knowledge, stigma, and quality of life in epilepsy: Results before and after a community-based epilepsy awareness program in rural Bolivia. Epilepsy & Behavior. 2019; 92: 90–97.
10. Giuliano L., Cicero C.E., Padilla S., Camargo M., Sofia V., Zappia M. et al. Knowledge, attitudes, and practices towards epilepsy among general practitioners in rural Bolivia: Results before and after a training program on epilepsy. Epilepsy & Behavior. 2018; 83: 113–118.
11. Giuliano L., Cicero C.E., Padilla S., Camargo M., Sofia V., Zappia M.  et al. Knowledge and attitudes towards epilepsy among nonmedical health workers in rural Bolivia: Results after a long-term activity in the Chaco region. Epilepsy & Behavior. 2018; 85: 58–63.
12. Boston University School of Public Health, Dept of Global Health, Access Observatory. Access Observatory 2019 Report. (online) available from . (accessed on 4 May 2020).
13. Sanofi – Access to Healthcare – Mental disorders and epilepsy factsheet – March 2020  (accessed on 4 May 2020)