No abstract

The white paper published by the Lancet Commission put forward surgery as a global health priority. In that paper, their findings showed that 5 billion people in the world do not have access to 'safe, affordable surgical and anesthesia services when needed,' and this inequity is more evident in lower- and middle-income countries (LMICs).   These deficits are even more profound in surgical subspecialties such as neurosurgery. The paper "Global Neurosurgery: The Unmet Needs," published in 2016, addresses the system-level thinking and programs required to address the needs of neurosurgical care in lower resource settings.   Neurosurgeons need to have influence, presence, and leadership role in advocating for the surgical system strengthening worldwide as it is estimated that there are 5 million emergency and essential neurosurgery neurosurgical services currently unmet, especially in LMICs.   Thus, in 2019, the World Federation of Neurosurgical Societies (WFNS) established the Global Neurosurgery Committee (GNC), an ad hoc committee dedicated to organizing and furthering global neurosurgical efforts. The Committee is co-chaired by Kee B. Park, MD, MPH from the United States, and Abdessamad El Ouahabi, MD from Morocco. The body of the GNC was the Committee of 22 neurosurgeons from 19 countries; the Secretariat Team primarily managed internal GNC operations with support from the later-added Junior Committee, both of which were international medical students and trainees. One of the objectives of this Committee is to promote advocacy efforts for neurosurgical care within universal healthcare coverage.   This paper explores the fifth "ADVOCATE" objective, including its significance, the GNC's efforts, and progress toward executing its defining targets.

The field of global surgery has gained attention since the publication of the Lancet Commission landmark report in 2015. The authors estimated that 5 billion people worldwide do not have access to safe, affordable surgical and anesthesia services. The paper “Global Neurosurgery: The Unmet Need,” published in 2016, launched the modern global neurosurgery era by advocating for the system-level thinking and programs required to address limited neurosurgical care in low-resource settings.   At present, many individuals, academic institutions, governmental agencies, and nongovernmental organizations (NGOs) are involved in the global neurosurgery movement. These include the Program in Global Surgery and Social Change at Harvard Medical School, Duke Global Neurology and Neurosurgery, Weill Cornell Tanzania Neurosurgery Project, CURE Children’s Hospital of Uganda, and the Virtue Foundation in Mongolia. Nonetheless, as global neurosurgery efforts continue to expand, it is essential to align global neurosurgery activity in order to prevent duplication of effort.   In 2019, the World Federation of Neurosurgical Societies (WFNS) established the Global Neurosurgery Committee (GNC) to promote access to safe, affordable, and timely neurosurgical care worldwide. The GNC initially included five primary objectives – Amplify, Align, Advance, Assimilate, and Advocate – with the sixth objective, Communication, added in 2021. In this manuscript, we provide an update on the Align objective team.