Gail Rosseau

This article is part of an ongoing initiative to provide peer-reviewed updates to neurosurgeons on pertinent activities and initiatives at the annual World Health Assembly (WHA). The 78th WHA, which convened in Geneva, Switzerland, from May 19 to 27, 2025, presented a crucial platform for global neurosurgical advocacy after the recent withdrawal of the United States from the World Health Organization. Neurosurgical care was featured throughout the advocacy agenda, with neurosurgical delegates from nine countries driving collaborative discussions and educational events throughout the week. We reviewed and synthesized the WHA resolutions and side events most relevant to global neurosurgical care. Key neurosurgical advances during WHA78 included: (1) the call to action to recognize traumatic brain injury as a chronic and notifiable condition, (2) the first biennial update on folic acid fortification implementation working toward next year's progress report, and (3) the expansion of sustainable catalytic financing systems for surgical care.

Background: Traumatic brain injury (TBI) is a leading cause of disability but one of the least recognized health problems in the world, affecting up to 69 million people annually. The associated lifelong disability in survivors, the loss of economic productivity, and being a risk factor for dementia consume 0.5% of global economic activity. Yet TBI is still largely invisible in national surveillance systems and not well represented in chronic disease frameworks. Consequently, governments are not equipped to provide proportional financing of acute care and long-term care of survivors, nor to build health care systems and resources for improving outcomes of TBI through policy frameworks targeting prevention, treatment, and equitable access. Objective: This commentary aims to provide a comprehensive picture of the global effort to formally recognize TBI as a notifiable and chronic condition, including the justifications for recognition, the formation of an international coalition of stakeholders, and the strategic plan for resolution at WHA79 of the World Health Assembly, one of the first concerted multinational efforts that occurred as a side event during the 78th World Health Assembly (WHA78) in May 2025. Methods: This commentary integrates information from epidemiological studies, global registries, and testimonies from people with lived experience of TBI. We analyze these data to develop policy needs and corresponding initiatives to address key needs. These include coordinated efforts to advocate change, such as technical briefings, consultations with stakeholders, and storytelling led by survivors, all of which informed and formed a part of the WHA78 side event. Our efforts have garnered wide, multi-sector support. Results: The WHA78 side event showed that ministries of health, neurosurgical, neurological, and rehabilitation societies, academic researchers, WHO representatives, and survivors all unprecedentedly support the recognition of the importance of TBI, facilitating national policies for its prevention and treatment via standardized surveillance. More than 30 non-governmental groups officially supported the campaign. A sponsoring member state made a public commitment to co-sponsor a WHA resolution, which set the stage for ongoing diplomatic progress and engagement across regions. Conclusion: To improve global brain health equity, access to long-term care, and the resilience of health systems, it is important to recognize TBI as a notifiable and chronic condition. A dedicated WHA resolution would make TBI a part of global health governance, making sure that it is counted, tracked, and dealt with as quickly and comprehensively as possible. It is both a technical necessity and a moral duty to help survivors and families and fight for justice in global health systems.

Introduction Climate change is increasingly recognized as a significant threat to global health. Environmental exposures such as air pollution, temperature fluctuations, and extreme weather events may influence the presentation and outcomes of neurosurgical diseases. However, there is limited synthesis of the literature on this intersection. Objective To systematically map the global literature evaluating the relationship between planetary health and neurosurgical conditions, with a focus on exposure types, disease outcomes, and geographic and economic disparities in research output. Methods We conducted a scoping review following PRISMA-ScR guidelines. PubMed, Embase, and Scopus were searched from 1995 to 2024 for English-language, full-text studies reporting primary data on environmental exposures and neurosurgical disease. Studies were categorized by exposure type, outcome, study design, WHO region, and World Bank income classification. Results Of 15,658 records screened, 203 studies met inclusion criteria. Most were retrospective (24%, n = 49), prospective (17%, n = 34), or time series analyses (15%, n = 30). Studies originated primarily from high-income countries (62%, n = 126), with fewer from upper-middle-income (31%, n = 63), lower-middle-income (1%, n = 3), and low-income countries (Conclusion There is increasing evidence linking environmental exposures to neurosurgical disease, particularly stroke. However, global disparities in research persist. Expanding research capacity and integrating planetary health principles into neurosurgery are essential for addressing emerging challenges in neurological health worldwide.