Letter to the Editor Regarding “The COVID-19 Pandemic and Global Neurosurgery: The Situation in Japan and the Philippines”

Letter:

We read with great interest the article by Matsumura et al.¹ recently published in WORLD NEUROSURGERY, in which the authors describe the situation in Japan and the Philippines resulting from the coronavirus disease 2019 (COVID-19) pandemic and its impact on global neurosurgery, emphasizing the problems and disparities between countries. Observing the difficulties of neurosurgery in different regions of the world owing to changes in health systems, disease burden, delays in management of immediate care diseases, among other complications,² we consider it necessary to comment on some aspects to be taken into account to break the current barriers to international collaboration, reflecting on the challenges to be faced in the postpandemic period, a period in which medical students, young researchers, and future surgeons must propose ideas and solutions through research.³

The research career per se is an educational tool that helps to broaden knowledge and, specifically in medicine, to make decisions based on evidence. Therefore, it should not be taken as a privilege of the greatest, but as a necessity that does not discriminate against socioeconomic strata or professional titles. In this sense, opportunities for a research career should be granted in an equitable manner and not only to individuals who have the privilege of attending an award-winning university, having a senior researcher as a tutor, or entering a postgraduate program. Under the public calamity due to the COVID-19 pandemic, many organizations, universities, and institutions have stopped funding projects and international exchanges, which hinders the development of academic and research skills of medical students and young researchers, especially in low- and middle-income countries.⁴ This situation should be addressed, as horizons should be broadened in search of new and better talents that surely have much to contribute to the field of neurosurgical research.

Opening doors to young researchers would not only contribute to health research, but also would strengthen the personal growth of these talented researchers. To this end, opportunities must be increased for the creation of plans that are applied and maintained over time, aimed at inclusion policies in the offer of academic careers in universities that do not depend on exclusive and inequitable criteria. This inequity is most evident in developing countries, where gender roles, privatization, and regionalization of resources isolate the possibilities for inclusion.⁵ For example, a few years ago, the United Nations determined that while the United States, Japan, and Korea invested 2.5%–3.0% of their gross domestic product in science and technology, Latin America and the Caribbean invested approximately 0.5% of their gross domestic product⁶; now, under the difficulties of COVID-19, how much will be invested in science and technology in low- and middle-income countries? The United Nations Educational, Scientific and Cultural Organization (UNESCO) established that among the goals for 2030, Latin America should be one of the great leaders in research, as there was evidence of an increase in participation in scientific publication for the year 2013.⁷ However, these data represent the progress almost exclusively of Brazil,⁷ a country that has most of the journals indexed in health sciences in databases such as SCImago Journal & Country Rank. Ciocca and Delgado⁵ described the day-to-day reality of research in Latin America, highlighting that the social and economic gap, including the abandonment of the state of support of scientists and young researchers, bureaucracy and other problems, is the cause of low productivity and low participation in international collaborations, which result in evidence of excellent quality.⁵

All policies necessary to promote research must be implemented and financed by the state, which is responsible for providing optimal conditions for research as well as for promoting education and the resolution of the major problems that affect public health. Research in itself is a discipline capable of transcending knowledge and improving the living conditions of humankind, so it is important to ensure that the academic community is interested in it and that the necessary opportunities are provided so that it can be practiced, produced, and used to provide solutions to local, regional, national, and international public health problems. It is necessary that international neurosurgical scientific societies design plans funded by the participants to support education and development projects that allow the continuity of scientific research and global neurosurgery.