The World Health Organization (WHO) announced these four "demonstration projects" at the launch of the second stage of its Global Campaign against Epilepsy. The four country projects are will serve as a model for other WHO Member States.

"Since 1997, WHO and its partner organizations have worked hard to alert people and governments around the world to the unnecessary suffering and loss caused by untreated epilepsy," said Dr Gro Harlem Brundtland, WHO’s Director-General. "We have developed concrete strategies to substantially improve treatment and the time has come to turn these ideas into results on the ground."

The four demonstration projects will assess the number of people suffering from epilepsy in the participating provinces and train primary health care workers within the existing primary health service how best to diagnose and treat epilepsy patients. Experiences with the projects will be used as a base for developing national programmes in the four countries and to assist other countries in designing their own projects.

Epilepsy is a neurological disorder that affects at least 50 million people world-wide. Around 85% of them living in developing countries. There are two million new cases occurring in the world every year.

Up to 80% of persons with epilepsy could lead normal lives if properly treated, but the overwhelming majority of patients does not get any treatment at all. WHO Regional Office for the Americas estimates that out of five million people with epilepsy in the region , 3.5 million are believed to be untreated. A recent survey of 30 Latin American countries revealed that none of them had national policies for epilepsy. In sub-Saharan Africa, there is one neurologist for four million people.

The global campaign, called "Out of the Shadows", is focusing on stigma and discrimination associated with epilepsy in the community, at the workplace, at school and at home. "Our aim is to improve treatment, prevention and social acceptance of epilepsy, the world’s most common – yet treatable – brain disorder," said Dr Brundtland.

More than 50 countries have so far joined the Global Campaign against Epilepsy spearheaded by WHO, the International League against Epilepsy and the International Bureau for Epilepsy.

"Our biggest challenge is to de-mystify epilepsy, to make people understand that there is nothing supernatural about it. Age-old superstitions die hard, be it in Cairo, Calcutta or Caracas", explains Dr Derek Yach, WHO Executive Director in charge of Mental Health. "Indeed, a law in the United Kingdom forbidding persons with epilepsy to marry was repealed only in 1970."

Physical, psychological and social impact of epilepsy is profound. It is not unusual for children with epilepsy to receive inadequate schooling. The rate of unemployment is two to three times higher for persons with epilepsy. Many would hide their condition. It contributes to social isolation, low self-esteem and can lead to depression and suicide.

This medical condition can be triggered off, especially in predisposed individuals, by any brain disease or injury, infections such as meningitis or encephalitis, vascular disease, tumour or alcohol abuse. Preventable parasitic diseases, malnutrition and inadequate care in childbirth are among common causes of epilepsy in developing countries.

"In developed countries our main goal is to improve quality of life for persons with epilepsy. But even there centuries-old superstitions are lurking in the shadows", explains Ms Hanneke M. de Boer of the International Bureau for Epilepsy. "It is a much more complicated situation in developing countries: social stigma and discrimination, lack of trained personnel and shortages of anti-epileptic drugs. Even when drugs are available they can be of sub-standard quality or too expensive to purchase".

The blueprint for the second stage of the global campaign was based on input from more than 1200 representatives from well over 100 countries around the world.