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Multiple sclerosis is on the rise in Australia, prompting calls for more government funding to improve research and data collection …
A new report has found the prevalence of people living with multiple sclerosis in Australia has increased at an alarming rate over the past few years, with a 30% increase of Australians living with the disease.
The findings were recently published in the Health Economic Impact of Multiple Sclerosis in Australia in 2021 report, commissioned by Multiple Sclerosis Australia and prepared by the Menzies Institute for Medical Research at the University of Tasmania.
The findings show 33 335 Australians were living with multiple sclerosis in 2021, equating to 131.12 per 100 000 people, up from 103.7 per 100 000 people in 2017.
Despite the increase, Multiple Sclerosis Australia CEO Rohan Greenland has told InSight+ multiple sclerosis is still relatively uncommon.
“However, if we let it go on like this, it will become a common disease before too long,” Mr Greenland said.
Why is the prevalence of multiple sclerosis rising?
Report author Professor Bruce Taylor, a Principal Research Fellow at the Menzies Institute for Medical Research and Clinical Neurologist at the Royal Hobart Hospital, told InSight+ the reasons for the increase in people living with multiple sclerosis are multifaceted and is a trend being seen around the world.
“We know that adolescent obesity has skyrocketed in the last 30 years and that may be one of the major drivers for increasing multiple sclerosis because we know obesity in adolescence and childhood can increase your risk of 1.5 to twofold,” Professor Taylor said.
“Apply that at the population level, you dramatically increase the overall risk of getting multiple sclerosis.”
Mr Greenland said another factor contributing to the disease may be living in places with less sunlight exposure.
“In Australia, the highest rates of multiple sclerosis are in Tasmania, and it is lower in Queensland,” Mr Greenland said.
“We and others hypothesise that it may be that low sunlight exposure was associated with low ultraviolet radiation and subsequently lower vitamin D levels. What we now know is giving people vitamin D to prevent multiple sclerosis essentially does not work, it has no real effect.
“There are multiple other ways that sunlight affects how your immune system works through multiple different pathways, not just vitamin D.
“The problem with sunlight is it is a two-edged sword because you get increased risk of skin cancer with increased sunlight exposure. So, we must be very careful about the public health message.”
Professor Taylor said other risk factors include smoking, although that is decreasing, and pregnancy in women.
“For Australian women, we know that each pregnancy reduces your risk of getting multiple sclerosis by about 25%,” Professor Taylor said. “Women are having fewer pregnancies, and they are having them later in life. The average age of having a first child is now over 30. And that’s right about when the risk of multiple sclerosis starts increasing significantly.”
Other research has found that prior infection with Epstein–Barr virus may be an important risk factor for developing the condition, as discussed in Professor Taylor’s 2022 perspective in the MJA.
“That’s a really interesting field of research as to whether there’s a potential mechanism by which we can prevent the disease or treat it by targeting the viral factor that is critical to its development,” Professor Taylor said.
The rising cost of multiple sclerosis
With increasing rates of multiple sclerosis comes increased cost to both the person with the condition and governments. The report states the annual cost per person of someone living with multiple sclerosis in Australia increased by $5075 from 2017.
The condition now costs $73 457 per person per year which includes direct costs borne by both the person with multiple sclerosis and governments, as well as indirect costs such as lost wages and lost productivity.
The report states this is substantially higher than other complex chronic diseases such as Parkinson disease ($53 318), type 2 diabetes ($5209) and long term cancer ($17 401).
At a critical point in research
Multiple Sclerosis Australia said treatments for multiple sclerosis have improved considerably in the past 15 years and the country is now at a critical point in research, with more improved treatments in the pipeline.
“We know that multiple sclerosis attacks the coating around the nerves in the central nervous system interfering with the signals between the brain and the body. And a lot of people refer to the ability to repair the damage that’s been done and remyelinate the nerves as a holy grail in multiple sclerosis research,” Mr Greenland explained.
Last week, Multiple Sclerosis Australia awarded more than $3 million in grants for multiple sclerosis research.
Twenty-two new multiple sclerosis-focused projects will receive funding, including studies that examine genetics, the impact of diet on brain health, and the repair and regeneration of cells.
The organisation believes recent developments mean society is at a critical junction for finding a possible cure.
“Depending on your definition of what a cure is, we are within striking distance. It’s not a pipe dream,” Mr Greenland said.
More funding needed
The new research has prompted calls from Multiple Sclerosis Australia to improve data collection.
The Australian Institute of Health and Welfare (AIHW) Chronic Conditions Unit currently publishes statistics on multiple sclerosis in Australia within the Australian Burden of Disease study.
However, this has limitations, according to an AIHW spokesperson.
“Many chronic conditions such as multiple sclerosis are difficult to find in existing datasets although we will look more closely at the methodology used by Menzies Institute for Medical Research using the Pharmaceutical Benefits Scheme data.
“The AIHW would welcome the opportunity to contribute more to the monitoring of multiple sclerosis and other neurological conditions in Australia,” they said in a statement to InSight+.
“However, our routine monitoring work relies on external funding to provide the resources needed to undertake data development activities and exploration of our routine data collections.”
Multiple Sclerosis Australia is also hoping for funding to enhance their research efforts.
“This report really is a wake-up call for governments,” Mr Greenland said.
“If they can boost the amount of money they put into multiple sclerosis, we can supercharge the research agenda and that will be an incredibly effective investment.”
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