Multiple sclerosis (MS) is increasingly emerging as a significant yet under-recognised neurological challenge in India, affecting people in their most productive years and often remaining undiagnosed until disability has already progressed.
Current estimates suggest that over one lakh people in India may be living with MS. However, experts believe the actual burden is likely higher due to underdiagnosis, lack of comprehensive registries and fragmented care systems.
A Disease Affecting the Young, Yet Often Missed
Dr. M.V. Padma Srivastava, Chairperson, Neurology at Paras Hospital, Gurugram, said MS “can no longer remain a silent disease in India,” as it predominantly affects young adults who are studying, working and building families.
She explained that MS is a chronic autoimmune condition that damages the myelin sheath in the brain and spinal cord, typically affecting individuals between 20 and 40 years of age. Women are nearly three times more likely to develop the disease than men.
Delayed diagnosis remains a major concern. In India, symptoms are often invisible, intermittent and misunderstood, while access to advanced imaging and specialist care is still uneven, particularly outside major cities. Studies have highlighted gaps such as limited large-scale prevalence data and suboptimal referral pathways to neurologists, which further delay diagnosis.
Treatment Gaps and Cost Barriers
The treatment gap in MS care continues to be significant. India-focused estimates place the age-standardised prevalence at 7.8 per 100,000, translating to around 110,000 patients, while Global Burden of Disease data suggests approximately 106,600 cases.
Despite advances in treatment, affordability remains a key barrier. MS medications are expensive and are often not adequately covered by insurance, making it difficult for patients to initiate or continue therapy.
Dr. Srivastava emphasised that early diagnosis and timely access to high-efficacy therapies can significantly alter disease progression, preventing irreversible disability and improving long-term outcomes. She said India needs standardised treatment guidelines, dedicated MS clinics, stronger healthcare infrastructure and greater awareness among medical professionals.
Invisible Disability, Visible Gaps
Beyond clinical care, MS presents a complex disability challenge. Many symptoms such as fatigue, cognitive impairment, chronic pain and mood disorders are not outwardly visible, making it difficult for patients to qualify for disability certification under existing frameworks.
Dr. Srivastava noted that policy reforms are necessary to ensure patients are not excluded from benefits simply because their disability is not visibly apparent.
Policy and Insurance Gaps Persist
Meenakshi Bhujwala, Treasurer of the Multiple Sclerosis Society of India, Delhi Chapter, highlighted the absence of a national registry as a key gap, limiting accurate data and weakening policy response.
She added that many insurance policies still fail to adequately cover chronic neurological conditions like MS, forcing families to bear high out-of-pocket expenses.
Bhujwala also called for a re-evaluation of disability norms under the Rights of Persons with Disabilities Act. She said the benchmark disability requirement should be waived for MS patients, as many are excluded from benefits despite experiencing significant functional limitations.
Infrastructure Challenges and Uneven Access
India’s neurological care infrastructure remains limited. Estimates suggest there are only about 2,500 neurologists in the country roughly one per million people with the majority concentrated in metropolitan areas.
This imbalance leaves patients in rural and semi-urban regions facing delayed referrals, repeated consultations and incomplete diagnostic pathways.
Beyond Medicine: A Policy Imperative
The conversation around MS is now expanding beyond clinical care into the policy domain. Advocacy groups are calling for a national framework under the Ministry of Health and Family Welfare, improved disability assessment systems, broader insurance coverage and stronger patient-support mechanisms.
Without systemic changes, MS care in India risks remaining delayed, costly and uneven.
A Shift in Perspective Needed
Clinicians emphasise that MS is not a niche neurological condition that can be managed quietly in specialised centres. It is a long-term disease that affects India’s young workforce, places a burden on families and highlights structural gaps in the healthcare system.
Recognising MS as a national health priority could enable earlier diagnosis, better access to treatment and more equitable disability support especially for patients whose symptoms are not always visible.