WFNS-WHO Liaison Committee Report



WFNS-WHO Liaison Committee Report

Gail Rosseau, Chair
Ulrick Sidney Kanmounye, Laura Lippa, Ruben Ayala, Jeff Blount

The COVID-19 pandemic has affected all of our professional activities. Perhaps no committee of the WFNS was more affected than the WFNS-WHO Liaison Committee (WHOLC), as WHO has been forced to devote all its attention to the pandemic and concerns regarding the infectious viral disease, equipment for care and vaccine development, delivery and administration. Although global surgery has not been the primary concern of WHO in 2020, advocates of global surgery have been able to attract the attention of the Director-General of WHO during this time, and these initiatives have continued despite the pandemic. (Fig 1).

Fig 1: WHO Director-General Dr Tedros addresses the G4 Alliance Permanent Council 11/2020.

Advocacy for global surgery and neurosurgery remains essential, therefore, the WHOLC partnered with other global surgery organizations during this time to keep attention on the goal of all surgeons: to advocate for timely, affordable, quality surgery for everyone, everywhere. Our committee has worked closely during 2020 with the G4 Alliance group born from the global surgery efforts on behalf of Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care (Fig 2). As of 2021, the G4 Alliance has nearly 70 member organizations working in more than 160 countries. Seven of the G4 Alliance organizations have a neurosurgical focus or are led by neurosurgeons: the WFNS Foundation, the Foundation for International Education in Neurological Surgery (FIENS), Cure International, Korle-Bu Neuroscience Foundation, ThinkFirst, Northwest School of Medicine in Peshawar, Pakistan, and the Spina Bifida & Hydrocephalus Care Foundation. In addition, the G4 Alliance has a collaborative partnership with InterSurgeon.

Fig 2: G4 Alliance President Ruben Ayala MD, 2020 Annual Meeting, Manila, Philippines.

The G4 Alliance, in partnership with the WFNS and others, presented a series of virtual webinars during the UN General Assembly. Called “From Pandemic to Progress”, the 4-part series was organized by SOTA organizations for an audience that included Diplomats and Ministries of Health. Among the many high-profile speakers were: Jim Yong Kim,MD, 12th President of the World Bank and Amb. Jimmy Kolker, former Asst Secretary for Global Affairs, US Dept of Health and Human Services. (to view the webinars, go to www.theg4alliance.org).

Fig 3: SOTA program speakers during the UN General Assembly 9/2020.

Fig 4: SOTA program during the UN General Assembly 9/2020.

WHOLC has partnered with the G4 Alliance and other stakeholders in spinal dysraphism advocacy to create a Folate Fortification Committee that advocates for the introduction of a folate fortification resolution at the 2022 WHO World Health Assembly (Fig 5).

Fig 5: WHOLC Chair Gail Rosseau at the G4 Alliance Annual Meeting describes the Folate Fortification Task Force activities.

FIENS Chairman Robert Dempsey says his organization is proud to be a participant in the G4 Alliance. He is particularly enthusiastic about collaborative initiatives launched in 2020 to support and expand neurosurgical training in Sudan, Tanzania, and Afghanistan, as well as a Global Visiting Professor Program.

The G4 Alliance is a significant partner of InterSurgeon (www.intersurgeon.org). Developed by pediatric neurosurgeons James Johnston MD and William Harkness MD, InterSurgeon (a registered charity in the United Kingdom) runs an online surgical platform to “lower the barriers to information access and facilitate global surgical partnerships” between high-income country (HIC) users and their colleagues in low- and middle-income countries (LMICs). Many WHOLC members are individual and/or institutional participants in InterSurgeon - and champion both its expansion and its collaboration with Help Lightning virtual surgical assistance software. (Fig. 6).

Fig 6: William Harkness MD (L) and James Johnston MD (R), co-founders of InterSurgeon.

Other G4 Alliance member organizations with a global neurosurgery focus include:

  1. CURE International: an American nonprofit organization that provides pediatric neurosurgical and orthopedic care to underserved populations. CURE has contributed significantly to the understanding and management of hydrocephalus through research, training, and service.
  2. Solidarity Bridge: an American NGO led by Richard Moser MD. Solidarity Bridge focuses on service delivery in South America (Bolivia and Paraguay).
  3. The Spina Bifida & Hydrocephalus Care Foundation: a Nigerian NGO advocating for folic acid fortification and birth defect surveillance policies.
  4. Korle-Bu Neuroscience Foundation: a Canadian NGO working in Ghana, Liberia, and Nigeria to increase neurosurgical service delivery and infrastructure.
  5. The ThinkFirst Foundation: ThankFirst (https://www.thinkfirst.org/) was founded jointly by the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) in 1986, with a mission to “prevent brain, spinal cord, and other traumatic injuries through education, research, and advocacy.” WHOLC informs the WHO Injury Prevention team of ThinkFirst programs.

In 2019, the WFNS created a Global Neurosurgery Committee (GNSC) to “coordinate the efforts of neurosurgical societies worldwide in improving access to timely, affordable, quality neurosurgery.” (www.globalneurosurgery.org). WHOLC partnered with GNSC and FIENS on a number of projects. The WFNS GNSC has developed a global action framework built on five pillars (the 5 As): amplify access to neurosurgical care, align all global neurosurgery activities, advance relevant research, assimilate neurosurgical capacity, and advocate for universal health coverage. GNSC activities overlapping those of WHOLC are carried out collaboratively.

Conclusion

WHOLC continues to work during the pandemic and beyond to advocate for access to neurosurgical care throughout the world by partnership with other global surgery stakeholders.

References

1. Lepard JR, Akbari SHA, Haji F, Davis MC, Harkness W, Johnston JM. The initial experience of InterSurgeon: an online platform to facilitate global neurosurgical partnerships. Neurosurg Focus. 2020;48(3):E15. doi:10.3171/2019.12.FOCUS19859.

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