Sep 27, 2018

Most countries with highest childhood autism rates lack resources

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Data: Global Burden of Disease Collaborative Network; Map: Andrew Witherspoon/Axios

The latest findings from the Global Burden of Disease Study (GBD) show 4.57 million children under five living with autism, or about one in 138 kids. The largest numbers of young autistic children live in developing or low- and middle-income countries, including over one million children each in South Asia and Sub-Saharan Africa, while the highest rates of childhood autism are seen in the Middle East, Central Asia and North Africa.

Why it matters: So much of the dialogue surrounding autism is focused on the U.S., Canada, and Western Europe that we often forget much of the world's childhood autism is concentrated in regions where health resources are limited.

The big picture: India has the largest number of autistic children (851,000), followed by China (422,000), Nigeria (207,000), Pakistan (172,000) and Indonesia (159,000). Vaccination rates are often low in these regions, further refuting already debunked claims about a link between vaccines and autism. In contrast, about 150,000 kids with autism live in North America and fewer than 140,000 in Western Europe.

Be smart: Some patient advocates might chafe at the idea that being on the autism spectrum qualifies as a “disorder” in the current iteration of the GBD. There is merit to this argument: For many parents, it’s mostly autism’s co-morbidities (including intellectual disabilities) that have adverse consequences. But the data are still valuable in assessing the need for services and assistance.

What’s next: The huge numbers of children on the autism spectrum living in resource-limited countries mean new and better global health policies are needed to ensure that they can receive access to care and support. Both de-stigmatizing autism and providing resources for the world’s children on the autism spectrum should be priorities for the United Nations.

Peter Hotez is a professor of pediatrics at Baylor College of Medicine, where he is also dean of the National School of Tropical Medicine, and the author of “Vaccines Did Not Cause Rachel’s Autism.”

Editor's note: The map legend has been clarified to show that the autism rates reflected are per 100,000 children under five.

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