Global synergistic actions to improve brain health for human development

Abstract

The global burden of neurological disorders is substantial and increasing, especially in low-resource settings. The current increased global interest in brain health and its impact on population wellbeing and economic growth, highlighted in the World Health Organization's new Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022-2031, presents an opportunity to rethink the delivery of neurological services. In this Perspective, we highlight the global burden of neurological disorders and propose pragmatic solutions to enhance neurological health, with an emphasis on building global synergies and fostering a 'neurological revolution' across four key pillars - surveillance, prevention, acute care and rehabilitation - termed the neurological quadrangle. Innovative strategies for achieving this transformation include the recognition and promotion of holistic, spiritual and planetary health. These strategies can be deployed through co-design and co-implementation to create equitable and inclusive access to services for the promotion, protection and recovery of neurological health in all human populations across the life course.

Fig. 1. Interrelationships among the domains of health and wellbeing.

Spiritual wellbeing involves finding and living one’s life purpose and understanding the values and beliefs that guide one’s actions^,. Spiritual wellbeing has a positive effect on brain health, physical health and mental health, which in turn have positive effects on social and planetary health.

Fig. 2. Brain health in the era of the Sustainable Development Goals.

The figure shows the 17 Sustainable Development Goals (SDGs) set out by the United Nations as a call to action to end poverty and other deprivations, and address climate change, by improving health and education, reducing inequality and driving economic growth. Brain health is central to attaining all of these goals but is particularly important for SDG 3 (health), which itself is central to the other SDGs.

Fig. 3. Developments in neurology and global initiatives propelling a ‘neurological revolution’.

A neurological revolution can be fostered by applying an interdisciplinary approach to the WHO Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022–2031 (IGAP), alongside other global health initiatives. A transdisciplinary scientific approach, incorporating arrays of biophysical and psychospiritual approaches, is required to define and understand the factors that contribute to brain health.

Fig. 4. The neurological quadrangle.

The neurological quadrangle could provide a framework to implement the WHO Intersectoral Global Action Plan on Epilepsy and other Neurological Disorders 2022–2031 (IGAP) to improve brain health and wellbeing across the lifespan. The quadrangle consists of four pillars — surveillance, prevention, acute care and rehabilitation — and a core, which lays the foundation for the pillars. The first pillar focuses on surveillance, research and innovation services for neurological disorders and their associated risk factors. The second pillar includes population-wide neurological health promotion, protection and preventive strategies. The third pillar aims to achieve affordable, effective and timely delivery of diagnostic, therapeutic and acute care services around the globe. The fourth pillar promotes access to multidisciplinary rehabilitative and palliative care for chronic and terminal neurological disorders in diverse settings. The core is aimed at building and strengthening health systems and enabling prioritization of neurological disorders by reinforcing governance, diplomacy, advocacy and population-wide intersectoral approaches for neurological health. The success of this framework relies on synergistic interactions among all aspects of the quadrangle.

Fig. 5. A global ecosystem to monitor and reduce the burden of neurological disorders.

Synergistic action from a broad coalition of multisectoral stakeholders is required to address the global burden of neurological disorders. Key stakeholders include the six Ps: patients, health-care service and product providers, policy-makers, payers, implementation partners and the general population. Implementation partners include neurology organizations and societies, non-governmental agencies and ministries of health, and country ambassadors will act as commissioners. The World Bank and other funders and philanthropists will be approached for funding and support. Adapted versions of the global ecosystem can be adopted as regional and national ecosystems to suit the respective implementation environments.