Welcome to Without Borders!

If you have even a passing interest in the “state of global neurology”, then Neurology: Without Borders will soon become your go-to source for keeping track of the science and politics of neurology beyond the US. Without Borders will serve as a primary, centralized source for up-to-date, scholarly perspectives and academic review of developments and research relevant to the advancement of medical education, research and care in resource-limited, global settings. And US Neurology has certainly been at the forefront of mainstream American medicine’s recent expansion into the global health arena.

In the past 5 years, a vibrant Global Health Section has arisen within the American Academy of Neurology (AAN) and integrated sessions focusing upon global health issues have become standard at the AAN’s annual meeting1, 2. The American Neurologic Association (ANA) has initiated an International Outreach Committee3, the AAN and American Epilepsy Society (AES) have joined forces with the International League against Epilepsy to draft shared clinical care guidelines4, and the American Brain Foundation has awarded at least three clinical research training fellowships to scholars conducting research outside of the US. More than half of US neurology residency programs now accommodate global health electives5 and a growing number of international stakeholders including the United Nations (UN), non-governmental organizations, and large private donors have developed interests and investments in neurologic conditions6. Of course, much of this is driven by the profound need for neurologic expertise in lower- and middle income countries (LMICS)–because despite carrying the preponderance of the world’s neurological burden of disease, LMICs are the very regions most poorly served by neurology today.

A substantial minority of US neurologists and neurology trainees are now engaged in activities abroad or are working within the US to support and develop international programs7. Unfortunately, keeping abreast of advances and issues in global neurology is challenging. With no strong academic tradition, advances in ‘global neurology’ are often dispersed amongst a plethora of publications ranging from regional societal periodicals to tropical medicine and subspecialty publications. Moreover, headline news in global health often has implicit implications for neurology abroad that aren’t immediately evident. Neurology: Without Borders will provide the ‘community’ of stakeholders engaged in neurological medical education, research endeavors and clinical care in global, resource-limited settings with a forum for timely and relevant communications about the most prescient issues, activities and developments pertinent to the advancement of neurology in these regions of the world.

As recently outlined by Roger Glass (Director for NIH’s Fogarty International Center) in the Nature supplement on Brain Disorders across the Lifespan8, these are interesting times for neurology globally. In much of the tropical world, the ongoing epidemics of neuro-infectious diseases are colliding with the tidal wave of emerging non-communicable disorders. Staying abreast of ‘interesting times’ can be a full-time job. Neurology: Without Borders will highlight and discuss contents of Neurology and developments further afield. It will offer a live ‘heat map’ providing markers related to global regions under discussion in the blog and in the printed journal. Informed people on particularly divisive topics will be asked to contribute in a debate-type/ pro vs. con forum for topics that best lend themselves to this approach (Is the NCD Alliance agenda a friend or foe of Neurology in LMICs? Any takers?). There will be interviews with key figures in the field—from leaders of major organizations to “boots on the ground”.

So happy 2016 and welcome to Neurology: Without Borders. Buckle up for what promises to be an exciting year for neurology abroad.

References

  1. Lee AC, Chin J, Birbeck GL, Bower J, Meyer AC. Creation of the AAN Global Health Section, part II: vision and goals. Neurology 2013;80:2151-2153.
  2. Lee AC, Chin J, Birbeck GL, Bower J, Meyer AC. Creation of the AAN Global Health Section, Part I: introduction and background. Neurology 2013;80:2062-2064.
  3. Feldman E. Message from the ANA President. ANA Newsletter [serial online] 2013;December 4, 2013:1.
  4. Birbeck GL, French JA, Perucca E, et al. Evidence-based guideline: Antiepileptic drug selection for people with HIV/AIDS: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Ad Hoc Task Force of the Commission on Therapeutic Strategies of the International League Against Epilepsy. Neurology 2012;78:139-145.
  5. Lyons JL, Coleman ME, Engstrom JW, Mateen FJ. International electives in neurology training: A survey of US and Canadian program directors. Neurology 2013.
  6. Mateen FJ. Neurology and international organizations. Neurology 2013;81:392-394.
  7. Birbeck GL, Hanna MG, Griggs RC. Global opportunities and challenges for clinical neuroscience. JAMA : the journal of the American Medical Association 2014;311:1609-1610.
  8. Glass RI. Brain disorders across the lifespan. Nature 2015;527:S150.
Gretchen L. Birbeck, MD, MPH

Gretchen L. Birbeck, MD, MPH

Gretchen Birbeck is a neurologist who divides her time between the US and Africa. Her US academic home is the University of Rochester where she is the Rykenboer Professor of Neurology and Research Director for the Strong Epilepsy Center with adjunct appointments in the Center for Human Experimental Therapeutics and the Department of Public Health. Her additional skills in epidemiology, health services research, and tropical medicine are brought to bear during the 6-months annually she spends in Africa where she serves as Director for the Chikankata Epilepsy Care Team in rural Mazabuka, Zambia, an Honorary Lecturer at the University of Zambia and a consultant for the Paediatric Research Ward at Queen Elizabeth Central Hospital in Blantyre, Malawi. Gretchen’s research programs are aimed at identifying opportunities to prevent or ameliorate the medical and social morbidities of common neurologic conditions in low-income, tropical settings with the ultimate goal of developing successful interventions feasible for scale up and broad implementation. She has been recognized as an Ambassador for Epilepsy by the International League against Epilepsy, a Global Health Research Ambassador by the US Paul Rogers Society, a National Outreach Scholar by the WK Kellogg Foundation and a Leader in Medicine by the American Medical Students Association.

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