Health Disparities in Rheumatic Diseases Understanding Global Challenges in Africa, Europe, Latin America, and Asia and Proposing Strategies for Improvement Dzifa Dey, MD, Msc, FWACP a, *, Savino Sciascia, MD, PhD b , Guillermo J. Pons-Estel, MD, PhD c , Huihua Ding, MD d , Nan Shen, MD, PhD d a Rheumatology Unit, Department of Medicine and Therapeutics, Korlebu Teaching Hospital, University of Ghana Medical School, College of Health Sciences, PO Box 4236, Korle-Bu, Accra, Ghana; b Center of Research of Immunopathology and Rare Diseases- Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, and SCDU Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Piazza del Donatore di Sangue 3, Turin 10154, Italy; c Centro Regional de Enfermedades Autoinmunes y Reumaticas (GO-CREAR), Rosario, Argentina; d Shanghai Institute of Rheuma- tology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China * Corresponding author. E-mail addresses: dzifakay@gmail.com; d.dey@ug.edu.gh KEYWORDS  Rheumatic diseases  Africa  Europe  Latin America  Asia, Disparities KEY POINTS  Rheumatic diseases are an emerging problem in Africa that require specialists with diag- nostic and research acumen and poor outcomes are multifactorial.  In Europe, challenges include access to diagnosis and treatment, mismatch between pa- tient expectations and provider strategies, and challenges in coordination of health and other social policies.  In Latin America, challenges include poverty, access to rheumatologists and rheuma- tology training programs, medication access and cost and general awareness about rheu- matic diseases.  In Asia, noting the significant diversity of ethnicity and culture across the continent, chal- lenges include delayed diagnosis and limited access to specialists and to treatment.  A unique strategy to help decrease disparities is promoting further rigorous research to leverage the potential benefits of traditional medicine. Rheum Dis Clin N Am 47 (2021) 119–132 https://doi.org/10.1016/j.rdc.2020.09.009 rheumatic.theclinics.com 0889-857X/21/ª 2020 Elsevier Inc. All rights reserved.