Unpacking Health Inequalities in SLE: A Global Primer

We're going in more detail in all of these points that you highlighted.

But let's start on the financial barriers.

This is actually not only for lupus patients.

Can you please just go through a little bit on global health in low to middle income countries and the financial barriers, both for patients, their families, and sometimes the carriers also?

Yes, absolutely.

You know, lupus is a distinct disease.

It's a unique disease.

And it largely, more importantly, it largely affects people in their peak productive years of life.

So these are the mothers.

These are the teachers.

These are the household bread earners.

So you imagine the socioeconomic impact on the individual or the patient, but also the community and the society, right? For example, when a 25 or so year old individual is diagnosed with lupus and needs to be absent from work or school or unable to care for her children.

So imagine the burden of illness, not just on the patient, but also on the family as well as the community.

And add to that the direct cost of frequent visits to a doctor and they have to undergo tests and take medications regularly.

Or worse, even require hospitalization in bad cases.

So you have loss of work productivity.

You have the burden of illness, not just in the patient, but also on the family and society in general.

Do you have a global idea in your practice of how many patients could not be able to continue working after a couple of years of diagnosis and treatment? Do you have a general idea?

Yeah, in general, there have been statistics that almost like from diagnosis, they lose about two weeks on diagnosis.

From diagnosis, they do not come to work for about two weeks on the average after that.

So you lose two weeks of work productivity.

And then on the long term, especially for those whose disease is not controlled or those who accumulate damage, And these patients now eventually need to resign from work or retire early from work.

That's even a major burden socially and economically, both for them and for all the society.

And how do you think that the social determinants of health, the poverty, the education, the environmental factors affect both the diagnosis of lupus, the access to healthcare, and even having access to medications like hydroxychloroquine? Is hydroxychloroquine already available? Yes,

steroids are readily available and hydroxychloroquine are readily available.