Press Release
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WCN 2015: “Changing Neurology Worldwide” – Santiago, Chile, 31 October– 5 November 2015
High global burden of neurological diseases recognized by political decision makers – knowledge transfer and exchanges to overcome inequalities
Neurological disorders cause considerable suffering, and they represent a high societal burden. 12 out of every 100 persons die as a result of neurological disorders. The important impact of these diseases on global health is increasingly recognized by international organizations and political decision makers. Although great progress is being made in diagnostic and therapeutic tools, appalling disparities in the availability of treatment persist: the new WHO Atlas shows that resources for neurological disorders hugely vary. Education and continued training as well as international knowledge transfer are crucial elements for ensuring the highest level of care globally.
Santiago de Chile, 31 October 2015 – “According to WHO estimates, neurological disorders are responsible for between 4.5 and 11 percent of all illnesses, depending on whether you are looking at low- or high-income-countries. This is far higher than the number of respiratory ailments, gastrointestinal disorders or cancers, and the burden is set to further increase in the years to come. As a specialty, neurology is moving at high speed, we are increasingly finding preventative, diagnostic, therapeutic and rehabilitative answers to the growing challenges posed by these diseases. At the same time, in many parts of the world patients still have totally inadequate access to neurological care”, Prof Raad Shakir, President of the World Federation of Neurology (WFN), emphasized at the World Congress of Neurology (WCN 2015). About 3,500 participants are gathered in the Chilean capital Santiago for the world's leading neurology event. “It is therefore an important step that the international community, governmental organizations and political decision makers increasingly recognize the high burden of neurological disease and the importance of neurology.”
Loss or impairment of many years of life – 12 out of 100 deaths caused by neurological diseases
According to WHO estimates, the number of disability-adjusted life years (DALYs) lost due to neurological diseases is expected to rise from 95 million worldwide in 2015 to 103 million in 2030. DALYs lost in connection with Alzheimer’s disease and other forms of dementia will rise most by around 28 percent. Equivalent years lost due to infectious neurological diseases, on the other hand, are expected to fall by 37 percent.
Neurological diseases are also a major cause of death: According to the WHO, they account for 12 percent of deaths worldwide on average. Low and lower-middle-income countries are the hardest hit. WFN President Shakir: “Of all neurological conditions, stroke and other cerebrovascular disorders are by far the most frequent cause of death, accounting for 85 percent of fatalities.”
High burden of disease moves up on the political agenda
The important impact of neurological diseases on global health is increasingly being discussed in the framework of governmental organizations, in particular the UN and the WHO. “Epidemiological studies have clearly identified the major importance of stroke and dementia, and now more recent documents also emphasize the growing role of neurological diseases affecting brain health in general. Neurological diseases are finally an integral part of the global political agenda of major health issues”, Prof Shakir stressed. Moreover, the WFN President emphasized the importance of care for brain diseases, as the cost of care mightdrive many economies close to bankruptcy. “This is clear with a view at the pace in which populations are ageing.At present, only in one country, Japan, more than30 percent of the population are aged older than 60 years. By 2050, there will be many, including Chile, China, Iran, andThailand. A sobering fact.”
In September, the United Nations summit for the adoption of the post-2015 development agenda agreed on 17 sustainable goals, including the objectives to “ensure healthy lives and promote well-being for all ages” and to “reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.” Neurological diseases are explicitly highlighted in the relevant UN resolution: “We are committed to the prevention and treatment of non-communicable diseases, including behavioural, developmental and neurological disorders, which constitute a major challenge for sustainable development.”
Not only the UN, also the WHO has been highlighting the importance of neurology at several instances, as the WFN President stressed: “In May, the World Health Assembly passed a resolution on epilepsy, a topic to which the WFN has devoted this year’s World Brain Day. In March, the first WHO Ministerial Conference on Global Action Against Dementia was held in Geneva. And the WHO Global NCD Action Plan 2013-2020 emphasizes synergies between major non-communicable diseases and other conditions, with examples such as epilepsy, Alzheimer’s and Parkinson’s disease and traumatic brain injuries. It also defines a number of targets that are highly relevant in the prevention of neurological conditions, such as a 30 percent reduction in salt intake, a 30 percent relative reduction of tobacco use, or a 25 percent relative reduction in the prevalence of raised blood pressure or maintaining the prevalence of raised blood pressure, according to national circumstances.”
WFN in collaboration with the WHO play an important role in the ICD 11 project, with WFN President ProfShakir chairing the Topic Advisory Group for Neurology of the WHO. The new international classification of diseases will be published in 2017. The work is now available online for public review and willbe field tested in 2016. Prof Shakir: “Cerebrovascular diseases are now part of brain diseases and this will importantly contribute to more precise statistics on neurological disability and death in the future. Dementiasand their various causes will be introduced in the category of diseases ofthe nervous system in ICD 11. The new ICD will have short definitions of every neurological disorder which will be an important aspect for its widespread use not only in specialized centres but also in primary care and resource poor settings across the globe.”
Large inequalities with respect to resources
The resources available for neurological diagnosis and therapy and access to neurological care are very unevenly distributed globally, as the new WHO Atlas presented at the WCN shows. The number of hospital bedsper 100,000 inhabitants, for example, is lowest in the African (0.23 per 100,000) and the Southeast Asian (0.28 per 100,000) regions of the WHO. The number of beds for neurology patients is significantly lower in low-income versus high-income regions in public hospitals (0.19/100,000 versus 11,73/100,000).
“While in high-income regions there are an average of 402 neurologists for every 100,000 inhabitants, in low-income countries the figure is only 4.5 which is far below acceptable levels”, said Prof Wolfgang Grisold, Secretary General of the WFN. “The same trend can also be seen among neurosurgeons or paediatric neurologists. We should also be aware that in some low income countries in sub-Saharan Africa, and some Asian countries such as Cambodia or Myanmar, the number of neurologists is even lower than these figures.”
Knowledge transfer and exchanges improve neurological care
“It is the clear goal of the WFN to foster quality neurology and brain health worldwide and to ensure access to good care for all patients,” said Prof Grisold. “High-quality neurological care hinges on a central lynchpin of sound education and advanced training. The 117 member societies that make up the WFN are therefore engaged in multiple projects with respect to advanced training opportunities.” The WFN places particular focus on international exchanges and the transfer of knowledge, such as junior travelling grants, international courses jointly with other international societies,WFN teaching centres or grants to fund local projects.
A CME program is offered, in collaboration with the American Academy of Neurology, to many countries where there is a need for neurological educational material. To date there are 45 countries participating in this program. Prof Grisold: „We also foster exchange and department visit from young neurologist to Europe, invited by national neurological societies in Turkey, Austria and Norway.”As an outstanding success, Prof Grisold also chronicled the establishment of WFN Teaching Centres in Africa. Two of these Centres are already in place in Rabat and Cairo, and two more, in Dakar and Cape Town, are in the process of application. “These are important stimuli for health care in less privileged parts of the world.”
WCN Press Contacts
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Local Media Contact
Verónica Neumann
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Sources: WHO: Neurological Disorders: Public Health Challenges, Chapter 2, Global Burden of Neurological Disorders. Estimates and Projections; WCN 2015 Presentation, Darun, Country resources for neurological care and training: The new WHO Atlas
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