Global Neurosurgery Committee Report

The Global Neurosurgery Committee (GNC) was created with the aim of aligning and coordinating the global neurosurgery activities of the different committees of the WFNS in order to foster collaborative and synergistic efforts. WFNS, as well as many other neurosurgical societies and organizations, has been actively involved in promoting and supporting global neurosurgery, and the goal of the GNC is to identify all the various stakeholders involved, develop partnerships, and coordinate their activities under the WFNS umbrella. We have been hard at work supporting and coordinating efforts by neurosurgeons around the world to collectively address the unmet need for neurosurgical care. These efforts have culminated in our goal to implement the Global Action Plan, details of which can be found on the website (https://globalneurosurgery.org/), by the next WFNS Special World Congress in Bogota, Colombia on August 29, 2021. We hope to have 100% of member societies pledging their support of the ideals detailed in the Global Action Plan (https://globalneurosurgery.org/globalaction-plan-supporters/) by the Congress.

Although we have been operating for only six months, we have been extremely productive with the help of our industrious committee members. Our projects have focused on three key areas: research, advocacy, and policy. Here is a snapshot of our projects:

• We are currently collecting data from neurosurgeons and national certification boards to detail the global neurosurgical workforce in 2020. As one of the key indicators of surgical capacity, health workforce should ideally be collected accurately and regularly. To that end, we encourage all WFNS member societies to begin the regular annual collection of such data for their representative countries with assistance from the GNC. We cannot improve what we do not measure, and only with the assistance of the member societies of the WFNS can we ensure that there is a sufficient number of neurosurgeons in each country to care for their patients. Anyone who wishes to initiate this process for their society can reach out to us at GNC.WFNS@gmail.com for assistance.

• Our other research projects include a broad range of topics such as the barriers to access and costs of training neurosurgeons, the out-of-pocket costs for patients of essential neurosurgical procedures, and the suitability and sustainability of donated neurosurgical equipment in low-resource settings. All of our projects are intended to yield data that can be directly used for policy and advocacy efforts to improve neurosurgical capacity, as in the culmination of our hydrocephalus and spina bifida comprehensive guidelines for prehospital, in-hospital and post-hospital care that are currently being finalized.

• The data collected will help to establish a global map for the needs in human resources, education, infrastructure, and equipment. This can then be combined with the available opportunities to match supply and demand, as we are currently building in our partnership with InterSurgeon (https://intersurgeon.org/) to develop a platform for neurosurgeons to more easily create partnerships and assist each other in building neurosurgical capacity.

• We are also advocating for research capacity building for neurosurgeons everywhere, especially in low- and middle-income countries so that local neurosurgeons are able to study local problems and find solutions for local priorities. As the recognition of the importance of public health in neurosurgery grows, we support the creation of global neurosurgery sections in neurosurgical journals, and the development of venues and conferences for the dissemination of global neurosurgical research.

• We have worked with the Neurosurgery Outreach Foundation to fund a research award for global neurosurgery research from low- and middle-income countries to be presented at the next Congress. Details and submission guidelines will be coming shortly, so spread the word and keep an eye out!

• The training of our future generations of neurosurgeons in the field of global neurosurgery is necessary to create leaders outside of the operating room. Leaders should understand the varying contexts in which neurosurgery is practiced, and so it is paramount that neurosurgeons from low- and middle-income countries have equitable access to these training opportunities. To that end, we are working with funders to develop grants for neurosurgeons and trainees from low- and middle-income countries to study public health and global neurosurgery at accredited fellowship programs like the Program in Global Surgery and Social Change at Harvard Medical School.

• Policy development and capacity building also extends to our national strategic planning and training initiatives, as we have initiated projects in multiple countries to support local neurosurgeons in their efforts. We are currently working with partners in Sudan, Afghanistan, Tanzania, Senegal, Myanmar, Bolivia, and the Caribbean to target local priorities for neurosurgical capacity building. Often, this includes developing training centers and obtaining educational resources as education is a priority, but targets include a wide range of objectives from building a surgical skills lab to increasing neurosurgical nursing and ICU capacity. It is important for these initiatives to have the support of ministries of health and be coordinated with national health initiatives, and our ultimate goal is for neurosurgery to be recognized as an integral part of any national healthcare strategic plans. For these initiatives to succeed it is critical to have the involvement and expertise of various WFNS committees, with the role of the GNC to coordinate and facilitate partnerships.

With the combined knowledge, experience and efforts of all WFNS members we can build a bright future for neurosurgery everywhere. We encourage any member who is interested in assisting to reach out to us at GNC.WFNS@gmail.com.