Creation of the AAN Global Health Section, Part II

Abstract

In the first part of this series, we outlined the current state of global health in neurology. In this second part, we provide an analysis of the role the AAN Global Health Section can play, and Section vision and goals.

In the first part of this series, we outlined the current state of global health in neurology. In this second part, we provide an analysis of the role the AAN Global Health Section can play and outline the Section's vision and goals.

What unique role can the AAN Global Health Section play?

There is growing interest in global health among American Academy of Neurology (AAN) members, and the creation of the AAN Global Health Section fills an unmet need for members with this interest. While other organizations are engaged in global neurology activities, their presence and activities are not well-known to the majority of the AAN membership. The AAN Global Health Section can promote health volunteerism among its members and serve as a resource for AAN members looking for coordinated activities to engage in global health, through partnerships and initiatives with other organizations.

While a number of individuals and institutions are currently engaged in global neurology activities, resources and information regarding proven practices or effective models of collaboration are often poorly disseminated. The AAN Global Health Section and online community can help to create a network for members to improve communication and collaboration that spans subspecialties.

The AAN has had a long-standing commitment to education and training programs in the United States. There is increasing interest from training programs in offering a global health track or international electives. Developing such opportunities may present unique ethical issues and challenges that may be unfamiliar to US-based programs.^1,2 The AAN Global Health Section can bring attention to issues of global health ethics, in order to encourage responsible global health activities.

The AAN has long been recognized for its development of exceptional educational programs. Critical to educational and capacity-building projects are appropriate educational curricula. With increasing availability of the Internet in low- and middle-income countries (LMICs), there are increasing opportunities for education via telecommunications with LMIC institutions linked to well-established neurology programs in developed countries. The AAN Global Health Section can help support the creation of standardized curricula and telecommunications programs that can be a resource for training neurologists and non-neurologists in LMICs.

Vision and objectives.

Advocacy.

Background.

There is an absence of neurologic representation in high-level policy discussions on global health. A United Nations High General Assembly on noncommunicable disease was convened in September 2011. Except for stroke, neurologic disorders were not addressed in meetings or outcome documents.^3,4

Strategic goal.

Increase visibility of neurologic issues in global health and involvement of neurology in global health policy discussions.

Operational strategy.

1. Identify and support efforts by other organizations advocating for neurologic disorders, such as the newly founded World Brain Alliance.

2. Identify ways in which the neurologic community can actively engage in policy discussions on global health.

Education.

Background.

There is growing interest in global health in neurology. At the same time, many North American neurologists are not well-informed of the pressing neurologic needs in LMICs. Overall there is a lack of neurologic educational and scientific programs related to global health, and lack of representation of members from LMICs.

Strategic goals.

1. Increase awareness and interest of global health issues within the AAN membership.

2. Increase involvement of international members in the planning and participation of AAN annual meeting programs.

Operational strategy.

1. Discuss potential courses and maintain discussions with other Sections on jointly sponsoring sessions at annual meetings.

2. Encourage and support submissions for educational and scientific content by international members.

3. Discuss with the Education and Scientific Committees ways to increase global health content.

Global training opportunities.

Background.

There is growing interest in global health among residents and training programs.

Strategic goal.

Provide guidance and support for programs on how to provide experiences that are both meaningful for trainees and minimize host burden, and how to train residents to be well-informed on global health issues, travel, safety, and ethics.

Operational strategy.

1. Create recommended core curriculum on global health neurology that residents partake in prior to an international exchange.

2. Compile information on neurology residency programs that have incorporated international electives or global health.

3. Compile information on and consider establishment of funding opportunities for trainees.

Supporting capacity building and education in LMICs.

Background.

There is a tremendous lack of neurologists in LMICs. Education of neurologists, general practitioners, and ancillary health workers is critical to decreasing the workforce gap and improving neurologic care in LMICs.

Strategic goals.

1. Develop and support neurology capacity-building efforts that minimize the potential for contributing to brain drain, in collaboration with existing organizations.

2. Promote global health volunteerism among AAN members, ranging from clinical care to education to research to mentorship.

Operational strategy.

1. Support development of core curricula and educational resources that can be used in capacity-building efforts.

2. Support development of telecommunication links between medical institutions in North America and LMICs.

3. Consider establishment of funding opportunities for bidirectional exchange.

4. Identify meaningful opportunities for AAN members to volunteer in global health settings.

Membership.

Background.

Mutual exchange and dialogue with neurologists in LMICs is critical to the success of Section initiatives.

Strategic goals.

1. Increase AAN membership of neurologists from LMICs.

2. Increase membership of Section.

Operational strategy.

1. Actively reach out to AAN members in LMICs and inform them of the formation of the Global Health Section.

2. Recommend further reduction in annual membership fees for low-income countries.

3. Publicize formation of the Global Health Section.

Collaboration and community.

Background.

Currently, members interested or engaged in global health neurology activities often do not know of others who may be working on similar endeavors or in similar regions of the world. Creating a network that identifies members and their work can help foster meaningful dialogue and collaboration on global health projects.

Strategic goal.

Improve communication among members engaged in global health activities.

Operational strategy.

Create a network and online platforms for members to communicate.

Discussion.

The global burden of neurologic disorders is comparable to HIV, and there is little capacity to provide care for neurologic disorders in LMICs. Neurologists need to play a more active role in ensuring that neurologic disorders are included in the global health agenda and are given the appropriate priority given their burden. The AAN Global Health Section is in a unique position to coordinate the growing interests and resources of AAN members engaged in global health, to collaborate with other neurologic organizations globally to achieve its goals of advocacy and education, and to work with the International Subcommittee and AAN leadership to strengthen the AAN's role in global health neurology.

While the above vision and goals are broad, in our short time as a Section, we have started working on the following specific items:

1. Discussing potential collaborations with other neurologic global health organizations.

2. Compiling global health training opportunities.

3. Disseminating a monthly newsletter on news, events, and opportunities.

4. Increasing global health programs at the AAN annual meeting: continuing and directing the course “Global Health Challenges: Neurology in Developing Countries”; proposal to and acceptance by the Science Committee of a Global Health abstract topic for 2013; and collaborating with the International Subcommittee on an Integrated Neuroscience Session, “Global Impact of Non-communicable Neurological Diseases,” for 2013.

We welcome membership into the Global Health Section. To join the Section, contact AAN Member Services at memberservices@aan.com. The full strategic plan can be found on the Global Health Section page on the AAN Web site (http://www.aan.com/go/about/sections/global). For members interested in being involved with specific objectives, feel free to contact us directly: Jerome Chin (chair, chinj@asapp.org) or Amy Lee (vice-chair, amylee@gmail.com).

AUTHOR CONTRIBUTIONS

All authors contributed to the conceptualization and content of the manuscript. Dr. Lee contributed to drafting the manuscript, and all other authors contributed to critical revisions of the manuscript for intellectual content.

STUDY FUNDING

No targeted funding reported.

DISCLOSURE

A. Lee and J. Chin report no disclosures. G. Birbeck has received research funding from the US NIH and the Dana Foundation for projects in sub-Saharan Africa. She has also received medical education grants from the World Federation of Neurology and the International League against Epilepsy to develop and implement programs in Zambia and Malawi. J. Bower has served as a consultant for Teva and Merz Pharmaceuticals. A.-C. Meyer has received honoraria and travel support from Abbott and has received drug donation from Valeant Pharmaceuticals. She has received research support from the Hellman Family Foundation, the American Academy of Neurology Practice Research Training Grant, and a Fogarty International Clinical Research Fellowship (5 R24 TW00798; 3 R24 TW00798-02S1). She is currently receiving research support from the NIH (1K01TW008764-01A1 and 1R21NS077858-01). Go to Neurology.org for full disclosures.