Hyman, 2007; Insel and Quirion, 2005). In developed countries these conditions are typically treated by highly trained specialists; however, developing countries do not have enough MNS specialists, and other resources, to diagnose and treat all comorbidities. This often can result in a failure to account for diagnostic complexity where it exists (Njenga, 2004). Therefore, casting a wide net over the spectrum of disease is especially important given the resource-constrained nature of SSA and the often comorbid nature of MNS disorders in the region.

This sentiment was echoed repeatedly by workshop participants, who noted that SSA countries have an opportunity to avoid the consequences that have resulted from separating disorders into various separate “mental health” or “neurology” silos, as other countries have done, and instead recognize the related nature of MNS disorders and thus leverage limited resources across the wide (and integrated) range of MNS disorders, in order to help patients who need care. Specialists are not needed specifically for neurology or psychiatry; individuals are needed who care for disorders of higher brain function (Hyman, 2007). Advancing the use of the term “MNS disorders” will allow policy makers, healthcare providers, and advocacy groups to focus on the widest range of diseases and medical conditions, explained Sheila Ndyanabangi from the Ministry of Health in Uganda.

THE MNS DISEASE BURDEN

“Disease burden” is a term used to convey how prevalent various diseases are. Donald Silberberg, professor at the Department of Neurology at the University of Pennsylvania School of Medicine, put it plainly, “The burden of disease can be viewed as the gap between current health status and an ideal situation in which everyone lives into old age free of disease and disability. Causes of the gap are premature mortality, disability, and exposure to certain risk factors that contribute to illness.”

One common source of disease-burden guidance comes from the regular World Health Reports by the WHO, which uses the disability-adjusted life years (DALYs) method to assess the impact of certain diseases. DALYs is the sum of potential years of life lost due to premature mortality, plus the years of productive life lost due to disability. An acknowledged shortcoming of the DALYs metric is that it does not include the social or economic impacts on individuals, families, communities, or health systems—or the true burden these diseases have on the lives of those who suffer from them and those who care for them. Recognizing



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