Rachel King

Welcome to the Atlas of MS help page.

I’m Rachel King and I manage the Atlas of MS project at the MS International Federation.

I’m here to help answer any questions you may have about the Atlas. Below you can find some frequently asked questions and answers. If your question is not answered below, please email me at [email protected] I will get back to you, and also post the question and answer below to help other people.

The Atlas is a key tool for organisations, health professionals and individuals when advocating for improved surveillance data, and better access to treatment, care and support. It has also been widely cited in the research literature.

The main aims of the Atlas are to:

  • highlight the global burden of MS and how this varies across the world
  • stimulate additional systematic data gathering, particularly data on the epidemiology of MS
  • highlight the barriers to accessing healthcare and treatments for MS and gaps in resources
  • encourage use of the data to advocate for change globally and nationally

The first data release from the 3rd Edition of the Atlas of MS shows the following key epidemiological findings – please see the full report for more detail:

  • There are 2.8 million people living with MS around the globe. This is the most accurate and up-to-date estimate of the number of people living with MS worldwide.
  • The estimated number of people with MS globally has increased from 2.3 million people in 2013. Several factors are likely to have contributed to the increase, including: better counting methods nationally and globally as well as improved diagnosis, people with MS living longer and global population growth. However, from the data available we cannot rule out that there may also be some increase in the risk of developing MS.
  • Every 5 minutes, someone, somewhere in the world is diagnosed with MS. (please note this is based on 75 reporting countries)

The estimate of 2.8 million people with MS is higher than our estimate of 2.3 million people in 2013. Several factors are likely to contribute to the increase including better counting methods nationally and globally since then, as well as improved diagnosis, people with MS being diagnosed earlier and living longer, and population growth. However, from the data available we cannot rule out that there may also be some increase in the risk of developing MS.

Due to changes in our calculation method, we cannot directly compare the 2020 figure to the global estimate from 2013. If we used the same methods, the global estimate would have increased by 30% in 7 years.

Experts from 115 countries completed the epidemiology survey, representing 87% of the world’s population - an increase from 106 participating countries in 2013.

Prevalence data quantity and quality has improved. Experts in 104 countries reported prevalence data in 2020 (representing 83% of the world population) compared with experts in 93 countries in 2013 (representing 79% of the global population). Additionally experts in 84% of the countries reporting prevalence data in 2020 were able to cite peer-reviewed publications, MS registries or electronic health records as their source, compared to 71% in 2013.

Availability of high quality epidemiology varies considerably across the world and despite improvements in the number of countries reporting data to the Atlas, there are still big gaps in our evidence on MS across the globe.

A 95% confidence interval was calculated around our estimated prevalence of 35.91 (36) per 100,000 people and we can be 95% confident that the estimated world MS prevalence per 100,000 people is between 35.87 and 35.95 per 100,000 people.

However, we need to bear in mind that lack of up-to-date or complete surveillance data, the complexities of diagnosis and other inequalities and barriers in terms of accessing healthcare within nations are likely to mean our calculation is an underestimate.

The global demographic profiles are consistent with the 2013 Atlas.

  • There are at least twice as many women with MS as there are men.
  • 32 years is the average age of an MS diagnosis. As this is an age when people might be finding a long-term partner, having children, and forging careers, it’s important that support mechanisms are available to enable people to live the lives they want.
  • MS doesn’t only affect adults - there are at least 30,000 people living with MS who are under 18. (Please note this is based on 47 reporting countries)
  • 85% of people with MS are diagnosed with relapsing-remitting MS, and 12% with progressive MS. The remaining 3% are given an unknown disease type on diagnosis.

Although MS has been described and named as a neurological disease in adults for well over 100 years, it is only in the past few decades that it has been recognised that MS can occur in children too. More and more physicians consider this as a possible diagnosis when presented with symptoms consistent with central nervous system demyelination.

Knowledge about the incidence, diagnosis and clinical management of pediatric MS has expanded significantly in the past 10-15 years as research and dissemination of data has increased among the medical community.

In 2007, an International Pediatric MS Study Group was founded with the support of MSIF and several MS organisations. The group has published consensus statements about the diagnosis and clinical care of children with MS and the most promising avenues of future research. Research into possible genetic and environmental factors that may cause MS is an area of special interest in this field as it could yield valuable information about the development of MS in adults.

Most people with MS are initially diagnosed with relapsing-remitting MS (RRMS), where symptoms appear (relapse) over a short period of time, lasting between a few days and a few months. The symptoms then resolve (remission), sometimes for a long time. In progressive MS, there is a gradual accumulation of disability, with or without relapses.

A smaller percentage will develop progressive MS from the outset (primary progressive MS).

The reasons for the difference in risk between men and women are unknown but a variety of factors are likely to be influencing it such as hormonal and genetic differences, as well as differing social, lifestyle and environmental exposures between the sexes.

The Atlas of MS is a powerful tool to raise awareness and drive changes that improve quality of life for people affected by MS across the globe. We call on governments, policy makers, healthcare professionals and the MS movement to make the most of this open-data resource by:

  1. Using and updating the statistics in the Atlas, to discover new insight, stimulate additional research, raise awareness of MS and support evidence-based advocacy efforts.
  2. Implementing systematic evidence collection in countries where there are gaps, particularly in low and lower middle income countries, to enable a more comprehensive understanding of the epidemiology of MS at the country, regional and global level.
  3. Prioritising the collection of incidence data to better understand the future trajectory of MS cases and plan healthcare resources for diagnosis and treatment accordingly.
  4. Recognising that some groups of the population are disproportionally affected by MS (females and young adults) and ensuring that this is accounted for as part of healthcare and support systems.
  5. Improving awareness that children and young people can develop MS. Enhance steps to collect data on pediatric cases as well as ensuring they have access to prompt diagnosis, the relevant treatments, specialist healthcare professionals as well as sufficient support for those affected and their families.
  6. Funding and implementing research projects to investigate how genetics, environments and other factors increase people’s chances of developing MS and identifying interventions that could prevent or delay onset.

The 2008 Atlas found that Ireland had the lowest number of neurologists per head in the European Union. MS Ireland used this to persuade the Irish government to increase this and, by 2013, the number of neurologists in Ireland had increased from 14 to 34.

We have also seen an increase in the number of countries in the Eastern Mediterranean with MS support groups, and in the availability of information for people with MS.

If you have an example of an improvement that the Atlas of MS has helped bring about, please email to let me know [email protected]

The Atlas of MS is a powerful advocacy tool. We have illustrated a few ways you can use the data and social media tools we have provided to raise awareness, get noticed or to support advocacy or our advocacy pages

We are very interested in hearing other suggestions for how the Atlas data (or similar data you have collected in your country) could be used in advocacy work so if you have any other ideas of how the data can be used in this way, please email to let me know [email protected]

Map

The Atlas data tool allows you to see how MS varies across the world on maps and charts. On the map view you can hoover your mouse over a country and a pop-up box will show the relevant data for that country. On the chart view, you can compare your country of interest vs the whole globe, and by the World Health Organization (WHO) regions and World Bank Income categories. Additionally you can download key statistics for a country of interest via the country factsheet, which is available in English Spanish or Arabic.

Navigation

Some statistics are shown in all 3 formats (map, chart, factsheet), others are only shown in one. You can choose the format you wish to view by selecting one of the 3 types of views (as indicated in the visual above) and you can find this at the top of the screen above the analytical tool. You can scroll down below the map/chart and factsheet to download the full report and view other content.

Sub Navigation

To choose the statistic you are interested in please click on the statistics category (at the moment though there is only data for Epidemiology, and country classification – Clinical Management will be released early 2021) and then you can choose the statistic you are interested in from the drop-down menu at: Find statistics for

Find a country

The maps show the data for all countries around the world and you can use the zoom +/- buttons at the bottom of the screen to magnify the map. If you are unsure of how to find a country you can also select this via the drop-down menu “Find a country” on the right hand side, below the blue band. Hoovering over a country will bring up a popup box which will show the relevant data.

Zoom

You can download the map by pressing the download button.

Download

On the chart view, you can change the country of interest by using the drop-down menu and it will show you all relevant countries

Chart

On the chart view you can see your country of interest, and compare this with the global total, the World Bank Income categories and the World Health Organization regions. The regions/categories that the country of interest falls into are shown in a darker orange (and with bolder text) so you can see if the country of interest is higher or lower compared to the average for the region/income category.

Download

The chart can also be downloaded.

To compare multiple countries you can download multiple charts or factsheets or you have the option of downloading the full data set to conduct your own analysis.

The data is open-source so you are welcome to use it, but please use the following citation:

Multiple Sclerosis International Federation – Atlas of MS – 3rd Edition (September 2020)

Please let us know if there has been a new epidemiology study in your country by emailing me at [email protected]. I will then get in touch to find out more about the study and the new data. We will need to verify and validate this data (which will include corresponding with the original country coordinator) prior to inputting it into our database.

Any new information you provide not only affects the data for your country, it also feeds into the global, regional and income aggregate totals that we report. We are in the process of agreeing how frequently we will upload any new data and new aggregate calculations and we will update this page once this is finalised.

We have provided some social media tools in English, Arabic and Spanish for you to use in your own country. You are welcome to translate these into your own language but if you do please could you share these with us by emailing [email protected].

We have provided an example social media plan and some example posts to give you an idea of the way you could use the social media tools – you do not have to follow this though if you have other ideas. You can create your own key messages based on the information available in the Atlas. Consider the needs and experience of people affected by MS in your country, and tailor the messages to your advocacy priorities. To access the social media tools and other assets please fill in the form and we will send you a link to access them.

You can find the key data from both the 2013 and 2008 Atlas in the full dataset. The 2013 report can be found here: http://www.msif.org/wp-content/uploads/2014/09/Atlas-of-MS.pdf and the 2008 here: https://www.who.int/mental_health/neurology/Atlas_MS_WEB.pdf

Stats Sub Navigation

You can see a visual representation of how the countries are grouped into the World Health Organization regions or World Bank Income Group (June 2019) in the map view of the analytical tool and by clicking on the drop-down menu to country classification and then selecting the appropriate map from the ’find the statistics’ drop-down. If you hoover over the country of interest with your cursor you will see the details in a pop-up box

Country
WHO Region
World Income Bank Level
(June 2019)
Afghanistan Eastern Mediterranean Low income
Albania European Upper middle income
Algeria African Upper middle income
American Samoa Western Pacific Upper middle income
Andorra European High income
Angola African Lower middle income
Antigua and Barbuda Americas High income
Argentina Americas Upper middle income
Armenia European Upper middle income
Aruba Americas High income
Australia Western Pacific High income
Austria European High income
Azerbaijan European Upper middle income
Bahamas, The
Bahrain Eastern Mediterranean High income
Bangladesh South-East Asia Lower middle income
Barbados Americas High income
Belarus European Upper middle income
Belgium European High income
Belize Americas Upper middle income
Benin African Low income
Bermuda Americas High income
Bhutan South-East Asia Lower middle income
Bolivia Americas Lower middle income
Bosnia and Herzegovina European Upper middle income
Botswana African Upper middle income
Brazil Americas Upper middle income
British Virgin Islands Americas High income
Brunei Darussalam Western Pacific High income
Bulgaria European Upper middle income
Burkina Faso African Low income
Burundi African Low income
Cabo Verde African Lower middle income
Cambodia Western Pacific Lower middle income
Cameroon African Lower middle income
Canada Americas High income
Cayman Islands Americas High income
Central African Republic African Low income
Chad African Low income
Channel Islands European High income
Chile Americas High income
China Western Pacific Upper middle income
Colombia Americas Upper middle income
Comoros African Lower middle income
Congo, Democratic Republic of African Low income
Congo, republic of African Lower middle income
Cook Islands Western Pacific Upper middle income
Costa Rica Americas Lower middle income
Cote d'lvoire African Lower middle income
Croatia European High income
Cuba Americas Upper middle income
Curaçao Americas High income
Cyprus European High income
Czech Republic European High income
Denmark European High income
Djibouti Eastern Mediterranean Lower middle income
Dominica Americas Upper middle income
Dominican Republic Americas Upper middle income
Ecuador Americas Upper middle income
Egypt Eastern Mediterranean Lower middle income
El Salvador Americas Lower middle income
Equatorial Guinea African Upper middle income
Eritrea African Low income
Estonia European High income
Eswatini African Lower middle income
Ethiopia African Low income
Fiji Western Pacific Upper middle income
Finland European High income
France European High income
French Polynesia Western Pacific High income
Gabon African Upper middle income
Gambia,The African Low income
Georgia European Upper middle income
Germany European High income
Ghana African Lower middle income
Gibraltar European High income
Greece European High income
Greenland European High income
Grenada Americas Upper middle income
Guam Western Pacific High income
Guatemala Americas Upper middle income
Guinea African Low income
Guinea-Bissau African Low income
Guyana Americas Upper middle income
Haiti Americas Low income
Honduras Americas Lower middle income
Hong Kong Western Pacific High income
Hungary European High income
Iceland European High income
India South-East Asia Lower middle income
Indonesia South-East Asia Lower middle income
Iran, Islamic Republic of Eastern Mediterranean Upper middle income
Iraq Eastern Mediterranean Upper middle income
Ireland European High income
Isle of Man European High income
Israel European High income
Italy European High income
Jamaica Americas Upper middle income
Japan Western Pacific High income
Jordan Eastern Mediterranean Upper middle income
Kazakhstan European Upper middle income
Kenya African Lower middle income
Kiribati Western Pacific Lower middle income
Korea, Democratic People's Republic of South-East Asia Low income
Korea, Republic of Western Pacific High income
Kosovo European Upper middle income
Kuwait Eastern Mediterranean High income
Kyrgyzstan European Lower middle income
Lao, People's Democratic Republic of Western Pacific Lower middle income
Latvia European High income
Lebanon Eastern Mediterranean Upper middle income
Lesotho African Lower middle income
Liberia African Low income
Libya Eastern Mediterranean Upper middle income
Liechtenstein European High income
Lithuania European High income
Luxembourg European High income
Macao SAR South-East Asia High income
Madagascar African Low income
Malawi African Low income
Malaysia Western Pacific Upper middle income
Maldives South-East Asia Upper middle income
Mali African Low income
Malta European High income
Marshall Islands Western Pacific Upper middle income
Mauritania African Lower middle income
Mauritius African Upper middle income
Mexico Americas Upper middle income
Micronesia, Federated States of Western Pacific Lower middle income
Moldova, Republic of European Lower middle income
Monaco European High income
Mongolia Western Pacific Lower middle income
Montenegro European Upper middle income
Morocco Eastern Mediterranean Lower middle income
Mozambique African Low income
Myanmar South-East Asia Lower middle income
Namibia African Upper middle income
Nauru Western Pacific Upper middle income
Nepal South-East Asia Low income
Netherlands European High income
New Caledonia Western Pacific High income
New Zealand Western Pacific High income
Nicaragua Americas Lower middle income
Niger African Low income
Nigeria African Lower middle income
Niue Western Pacific Low income
North Macedonia European Upper middle income
Northern Mariana Islands Western Pacific High income
Norway European High income
Oman Eastern Mediterranean High income
Pakistan Eastern Mediterranean Lower middle income
Palau Western Pacific High income
Palestinian Authority Eastern Mediterranean Lower middle income
Panama Americas High income
Papua New Guinea Western Pacific Lower middle income
Paraguay Americas Upper middle income
Peru Americas Upper middle income
Philippines Western Pacific Lower middle income
Poland European High income
Portugal European High income
Puerto Rico Americas High income
Qatar Eastern Mediterranean High income
Romania European Upper middle income
Russian Federation European Upper middle income
Rwanda African Low income
Saint Kitts and Nevis Americas High income
Saint Lucia Americas Upper middle income
Saint Vincent and the Grenadines Americas Upper middle income
Samoa Western Pacific Upper middle income
San Marino European High income
Sao Tome and Principe African Lower middle income
Saudi Arabia Eastern Mediterranean High income
Senegal African Lower middle income
Serbia European Upper middle income
Seychelles African High income
Sierra Leone African Low income
Singapore Western Pacific High income
Sint Maarten (Dutch part) Americas High income
Slovakia European High income
Slovenia European High income
Solomon Islands Western Pacific Lower middle income
Somalia Eastern Mediterranean Low income
South Africa African Upper middle income
South Sudan African Low income
Spain European High income
Sri Lanka South-East Asia Upper middle income
St Martin (French part) Americas High income
Sudan Eastern Mediterranean Lower middle income
Suriname Americas Upper middle income
Sweden European High income
Switzerland European High income
Syrian Arab Republic Eastern Mediterranean Low income
Taiwan Western Pacific High income
Tajikistan European Low income
Tanzania, United Republic of African Low income
Thailand South-East Asia Upper middle income
Timor-Leste South-East Asia Lower middle income
Togo African Low income
Tonga Western Pacific Upper middle income
Trinidad and Tobago Americas High income
Tunisia Eastern Mediterranean Lower middle income
Turkey European Upper middle income
Turkmenistan European Upper middle income
Turks and Caicos Islands Americas High income
Tuvalu Western Pacific Upper middle income
Uganda African Low income
Ukraine European Lower middle income
United Arab Emirates Eastern Mediterranean High income
United Kingdom European High income
United States of America Americas High income
Uruguay Americas High income
Uzbekistan European Lower middle income
Vanuatu Western Pacific Lower middle income
Venezuela Americas Upper middle income
Vietnam Western Pacific Lower middle income
Virgin Islands Americas High income
Yemen Eastern Mediterranean Low income
Zambia African Lower middle income
Zimbabwe African Lower middle income