Volume 83, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Recent concerns regarding antiepileptic drug (AED) availability in Zambia led us to conduct a study in the Lusaka and Southern Provinces to quantify the availability and cost of AEDs and assess determinants. Among 111 pharmacies, almost one-half did not carry AEDs ( = 54; 49.1%). Available AEDs were phenobarbitone (21; 18.9%), carbamazepine (27; 24.3%), valproic acid (4; 3.6%), and phenytoin (3; 2.7%). Adult out-of-pocket monthly costs ranged from US $7 to $30. Pediatric syrups were universally unavailable. Interviews revealed several barriers to AED provision, including that handling phenobarbitone (historically the most affordable AED) has become increasingly difficult because of newly enforced regulatory requirements. Personal communications with epilepsy-care providers in other low income countries suggest that this problem may be widespread. Improved enforcement of existing drug regulations may be contributing to the AED shortage. Social programs aimed at encouraging people with epilepsy to come “out of the shadows” must be preceded by improved AED access.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. WHO, 2006. Disease Control Priorities Related to Mental, Neurological, Developmental and Substance Abuse Disorders. Geneva, Switzerland: World Health Organization. [Google Scholar]
  2. Meyer A, Dua T, Ma J, Saxena S, Birbeck G, , 2010. Global disparities in care for epilepsy: a systematic review and analysis of variation of the epilepsy treatment gap. Bull World Health Organ 74: 262268. [Google Scholar]
  3. Das K, Banerjee M, Mondal GP, Devi LG, Singh OP, Mukherjee BB, , 2007. Evaluation of socio-economic factors causing discontinuation of epilepsy treatment resulting in seizure recurrence: a study in an urban epilepsy clinic in India. Seizure 16: 601607.[Crossref] [Google Scholar]
  4. Pal DK, Chaudhury G, Sengupta S, Das T, , 2002. Social integration of children with epilepsy in rural India. Soc Sci Med 54: 18671874.[Crossref] [Google Scholar]
  5. Pal DK, Das T, Sengupta S, Chaudhury G, , 2002. Help-seeking patterns for children with epilepsy in rural India: implications for service delivery. Epilepsia 43: 904911.[Crossref] [Google Scholar]
  6. de Boer HM, Engel J, Jr Prilipko LL, , 2005. “Out of the shadows”: a partnership that brings progress! Epilepsia 46 (Suppl 1): 6162.[Crossref] [Google Scholar]
  7. Li LM, Fernandes PT, Noronha AL, Marques LH, Borges MA, Cendes F, Guerreiro CA, Zanetta DM, de Boer HM, Espindola J, Miranda CT, Prilipko L, Sander JW, , 2007. Demonstration project on epilepsy in Brazil: situation assessment. Arq Neuropsiquiatr 65 (Suppl 1): 513.[Crossref] [Google Scholar]
  8. Reynolds EH, , 2001. ILAE/IBE/WHO Global Campaign “out of the shadows”: global and regional developments. Epilepsia 42: 10941100.[Crossref] [Google Scholar]
  9. Management Sciences for Health, 2007. International Drug Price Indicator Guide. Geneva, Switzerland: World Health Organization. [Google Scholar]
  10. World Health Organization/African Regional Office (AFRO), 2007. AFRO Essential Medicines. Available at: http://www.afro.who.int/edp/publications/afro_essential_medicine_price_indicator_2007.pdf. Accessed February 1, 2010. [Google Scholar]
  11. Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R, , 2009. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet 373: 240249.[Crossref] [Google Scholar]
  12. Birbeck GL, , 2000. Seizures in rural Zambia. Epilepsia 41: 277281.[Crossref] [Google Scholar]
  13. Nations U, , 1971. Proceedings of the Convention on Psychotropic Substances. Vienna, January 11–February 21, 1971. [Google Scholar]
  14. WHO, 2001. Epilepsy Management at Primary Health Level: Protocol for a Demonstration in the People's Republic of China. Geneva, Switzerland: Department of Mental Health and Substance Dependence Noncommunicable Diseases and Mental Health Cluster, Neurological Diseases and Neuroscience, World Health Organization. [Google Scholar]
  15. Smith F, , 2009. Private local pharmacies in low- and middle-income countries: a review of interventions to enhance their role in public health. Trop Med Int Health 14: 362372.[Crossref] [Google Scholar]
  16. United States State Department, 2009. Zambia Country Data. Available at: http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/AFRICAEXT/ZAMBIA. Accessed February 1, 2010. [Google Scholar]
  17. Birbeck G, Chomba E, Atadzhanov M, Mbewe E, Haworth A, , 2007. The social and economic impact of epilepsy in Zambia: a cross-sectional study. Lancet Neurol 6: 3944.[Crossref] [Google Scholar]
  18. Chisholm D, , 2005. Cost-effectiveness of first-line antiepileptic drug treatments in the developing world: a population-level analysis. Epilepsia 46: 751759.[Crossref] [Google Scholar]
  19. World Health Organization, 2007. The World Health Organization Fifteenth Model List of Essential Medicines. Available at: http://www.afro.who.int/edp/publications/afro_essential_medicine_price_indicator_2007.pdf. Accessed February 1, 2010. [Google Scholar]
  20. World Health Organization, 2007. The World Health Organization First Model List of Essential Medicines for Children. Geneva, Switzerland: World Health Organization. [Google Scholar]
  21. Farkhondeh M, Hill SR, Cross JH, Dua T, , 2009. Antiepileptic drugs in children in developing countries: research and treatment guideline needs. Epilepsia 50: 23402343.[Crossref] [Google Scholar]
  22. Twagirumukiza M, Cosijns A, Pringels E, Remon JP, Vervaet C, Van Bortel L, , 2009. Influence of tropical climate conditions on the quality of antihypertensive drugs from Rwandan pharmacies. Am J Trop Med Hyg 81: 776781.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 15 Feb 2010
  • Accepted : 28 Apr 2010
  • Published online : 07 Sep 2010

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error