Imagine that you have just had a traffic accident. You hit your head hard and you’re bleeding. You may have a head injury. In Spain you can find a specialist to help you in less than an hour: an ambulance or a medicalized helicopter will take you to the nearest hospital where a neurosurgeon works. In Sierra Leone, nobody could help you. There, as in 30 other countries in the world, he does not exercise any. Your luck would be so lopsided if you had been diagnosed with a brain tumor or hemorrhage.
Not all health systems are prepared to deal with neurological diseases and injuries. There are profound inequalities in the resources that countries allocate to the care of these patients. Global neuroscience is an area of knowledge that integrates medicine, surgery, psychology, biology or economics to study the science of the nervous system and contribute to social change. And it shows that neurological problems are a growing social challenge throughout the world. In the European Union alone, the number of years lost attributable to neurological disorders was 21 million in 2017. The social impact of degenerative neurological diseases such as Alzheimer’s has increased in aging societies such as Spain. In turn, the incidence of neurological diseases such as pediatric hydrocephalus is higher in poor countries than in rich countries.
In the European Union alone, the number of years lost attributable to neurological disorders was 21 million in 2017
The VIU-NED Chair of Global Neuroscience and Social Change –created a year ago by the International University of Valencia (VIU) and the Valencian foundation Neurosurgery, Education and Development (NED)– seeks to study these inequalities, focusing on understanding the problems associated with brain diseases and other neurological disorders in low-resource countries. It brings together specialists from different branches of neuroscience in order to promote teaching, research and dissemination in this field of study.
But how can knowledge contribute to social change? This relationship is best appreciated where there are many problems but few experts to deal with them. In these contexts, small advances can achieve a great impact on society. For example, training one more neurosurgeon in Japan – the country with the highest density of neurosurgeons per inhabitant in the world – will hardly change the health care that the Japanese receive. However, doing so in Sierra Leone can be the difference between life and death for hundreds of people with a neurological diagnosis.
As a study published in The Lancet shows, the surgical needs of the world’s population are enormous. In 2015, the World Surgery Expert Commission estimated that 5 billion people remained without access to safe and affordable surgical care. In low-income countries, the doors of an operating room are closed for nine out of 10 people. For this reason, the VIU-NED Chair gives priority to the Global Surgery 2030 program, an international initiative that seeks to improve surgical care for the most disadvantaged populations.
In low-income countries, the doors of an operating room are closed for nine out of 10 people
One way to change this reality is by training local specialists; in particular, in those complex subspecialties such as neurosurgery, in which the deficiencies are more extreme. The VIU-NED Chair is training African health professionals, with a greater presence in Zanzibar (Tanzania), where the NED Foundation has its healthcare headquarters. The first female neurosurgeon in the history of Zanzibar, Dr. Muly, is training there. In addition, the chair promotes research on the approach to neurological patients in low-resource health systems. In this way, research, teaching and clinical-surgical training are combined to promote social change.
Beyond this experience, global neuroscience has the potential to transform our societies. We know more and more about how the brain works and why it fails when it gets sick. New experimental treatments are published every week. Today there are more research groups trying to solve problems that previously seemed unattainable. All this can serve to improve our lives, especially where poverty often kills before disease.
Jose Piquer Martinez is director of the Foundation for Neuroscience, Education and Development (NED). Maria Jose Garcia Rubio She is co-director of the VIU-NED Chair in Global Neuroscience and Social Change and a professor at the Faculty of Health Sciences at the International University of Valencia (VIU).
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