Epilepsy and Post-Traumatic Epilepsy (PTE) are major but often overlooked public health challenges globally, across Africa, and in Uganda. Epilepsy affects more than 50 million people worldwide, yet many people, especially in low- and middle-income countries, still lack access to proper diagnosis, treatment, and long-term care. PTE, which develops after traumatic brain injury, is becoming an increasing concern due to rising road traffic injuries, violence, conflict, and untreated head trauma.

Africa carries a disproportionate burden, with an estimated 15–40 million people living with epilepsy and a treatment gap of up to 90–95% in Sub-Saharan Africa. This burden is worsened by limited neurological services, few specialists, poor access to diagnostic tools, medicine stockouts, weak referral systems, and deep-rooted stigma. In many communities, epilepsy is still associated with witchcraft, spirits, or contagion, causing exclusion from school, work, marriage, and community life.

In Uganda, an estimated 850,000 to 1.2 million people live with epilepsy, yet fewer than 10% receive adequate medical treatment. PTE is likely rising due to boda-boda crashes, occupational injuries, conflict-related trauma, and underrecognized neurological conditions among refugees and displaced populations. However, Uganda lacks strong post-TBI follow-up systems, epilepsy registries, adequate diagnostic services, and a dedicated epilepsy surgery programme.

Addressing this silent burden requires urgent investment in community-based epilepsy care, reliable access to antiseizure medicines, health worker training, PTE surveillance, stigma reduction, and stronger research. With coordinated action, Uganda can become a regional leader in neurological health equity and ensure that people living with epilepsy receive the care, dignity, and support they deserve.