To compete in international markets and to build stronger national and local infrastructures, developing countries must produce well-educated workers, a process that begins with prenatal care and continues through the adult years of employment. Since many brain disorders interfere not only with health but also with education, they present an especially insidious limitation to developing economies. The consequences for a country's development of ignoring the burden imposed by these disorders are clearly large, and growing larger.
These disorders create, special problems for developing countries not only because of the scarcity of resources available to address them but also because of their mutually reinforcing relationship with poverty. Poor women bear an even heavier burden than poor men as a result of several gender-specific risk factors, many of which are preventable. The implementation of cost-effective interventions can help to reduce the impact of these disorders and break this debilitating cycle. Thus, poverty and gender inequality, which contribute greatly to the burden of brain disorders in developing countries, should be viewed as a target of the recommendations made in this report.
Despite the increasingly significant contribution of brain disorders to disease burden, these conditions are largely missing from the international health agenda. Stigma, discrimination, economic and gender inequalities, and lack of capacity for addressing these add to their burden in developing countries. Recognizing the importance of brain disorders is the first step toward reducing this burden. The process can be further advanced through increased understanding of the social and economic effects of brain disorders as well as through provision of cost-effective care.
1. R. Desjarlais, L. Eisenberg, B. Good, and A. Kleinman. World Mental Health. Oxford University Press: New York, 1995.
2. World Bank. World Development Report: Investing in Health Research Development World Bank: Geneva, 1993.
3. N. Sartorius, T. B. Ustun, J. A. Costa e Silva, D. Goldberg, Y. Lecrubier, J. Ormel, et al. An international study of psychological problems in primary care. Preliminary report from the World Health Organization Collaborative Project on “Psychological Problems in General Health Care.” Archives of General Psychiatry Oct,50(10):819–824, 1993.
4. T. B. Ustun. The Global Burden of Mental Disorders. American Journal of Public Health Sept. 89(9), 1999.
5. C. Murray and A. Lopez, eds. The Global Burden of Disease. The Harvard Press: Boston, 1996.