In Reply: Operationalizing Global Neurosurgery Research in Neurosurgical Journals

Abstract

The authors 1 raised the important question of why there should be a need for a new "global" section in neurosurgical journals, with supporting evidence that a) less than 10% of neurosurgical publications are produced by members of low-income and lower to middle-income countries, of which Egyptian and Indian authors produce 75% 5 ; b) most publications specific to traumatic brain injury care originate from Australia, China, Europe, Japan, and North America, all the while the traumatic brain injury disease burden is endemic to Africa, Latin America, and South East Asia 6 ; c) published randomized controlled trials, which inform clinical management and influence policy, receive only 9% of contributions from authors in low-and middle-income countries (LMICs). 7 We agree with the comments raised forth by the authors and concur that neurosurgeons and scientists from high-income countries (HICs) must work together with colleagues in LMICs to implement policies applicable to their respective terrains. Recommendations of the Colombian Consensus Committee from the Beyond One Option for Treatment of Traumatic Brain Injury: A Stratified Protocol (BOOTStraP) 8,9 are indeed effective and appropriate policy implementation measures to improve patient outcomes and quality of life; we agree with the authors. 1 Similarly, since 2001, The University of Pennsylvania School of Medicine has partnered with the Government of Botswana Ministry of Health and the University of Botswana to build healthcare and increase research capacity, currently employing more than 120 fulltime staff in the country. This growing Botswana-UPenn partnership has allowed for interdisciplinary care, development of postgraduate training programs at the University of Botswana, and joint research programs addressing the health and welfare of the citizens of Botswana. At Harvard Medical School, the Program in Global Surgery and Social Change has helped bridge the gap addressed by the authors through advocacy, capacity building, policy implementation, research endeavors, and systems strengthening. Moreover, at