Author Proof 1 ISSN 1758-2024 Neurodegen. Dis. Manage. (2011) 1(3), xxx–xxx 10.2217/NMT.11.28 © 2011 Future Medicine Ltd 1 Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy 2 Korle Bu Teaching Hospital, Accra, Ghana 3 Comboni Hospital, Sogakofe, Ghana 4 Centro Malattie Neurodegenerative, Salerno, University of Salerno, Italy 5 IDC Hermitage-Capodimonte, Naples, Italy 6 Chirundu Mission Hospital, Chirundu, Zambia † Author for correspondence: Tel.: +39 257 993 532; Fax: +39 257 993 319; roberto.cilia@gmail.com  Epidemiological issues & risk factors – Parkinson’s disease (PD) incidence is going to increase in sub-Saharan African countries as a consequence of a demographic transition. – Few data about the genetic background of PD and environmental hazards possibly leading to neurodegeneration are available so far in sub-Saharan Africa.  Diagnostic & therapeutical issues – In Africa there is a grossly inadequate number of medical doctors let alone neurologists, while dopaminergic medications are largely unavailable and/or expensive. Therefore, most individuals with PD are underdiagnosed and undertreated. – Adequate sensitization and training of local physicians, medical assistants as well as nurses and other health oicers about PD may improve patients’ identiication and long-term management.  The costs of PD in developing countries – Most people with PD in rural sub-Saharan regions cannot aford long-term levodopa treatment because the average salary is less than US$2/day. – Patients’ inability to work is an indirect cost because it further reduces familial income.  Our 2-year experience in Ghana & Zambia: objectives & methods – We are currently conducting a project whose objectives include provision of free and long-term treatment to all PD cases identiied in Ghana and Zambia and regular clinical follow-up from a team of neurologists and nurses.  Future perspective – A large international Task Force made up of neurologists, general practitioners, medical assistants, nurses and other health professionals with inancial support by Foundations is needed to face the challenge of PD in developing countries. Practice Points Parkinson’s disease in sub-Saharan Africa: step-by-step into the challenge SPECIAL REPORT Roberto Cilia †1 , Albert Akpalu 2 , Momodou Cham 3 , Alba Bonetti 1 , Marianna Amboni 4,5 , Elisa Faceli 6 & Gianni Pezzoli 1