Can we improve outcomes in MS around the world? Access and global considerations across income strata

The past decade has seen impressive success in therapies for MS. Over the span of only a few decades, we have moved from a world with no approved MS therapies to breakthroughs leading to low-moderate efficacy therapies, to high efficacy therapies and a multiplicity of therapeutic choices. Moreover, our diagnostic criteria have led us to an earlier and hopefully more precise MS diagnosis. This has resulted in earlier intervention and a marked reduction in clinical relapses and focal MRI activity in treated people with MS (PwMS). Due to this remarkable change in practice, we now expect “no evidence of inflammatory disease activity” in treated PwMS. Sadly, however, this state exists only in situations where MS therapies are readily accessed.