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Envisioning A New Age of Global Health in Neurology: Greetings from the WNFO Blog Editor

Growing up on a farm in a small Bavarian Village, I have always been curious about what was happening in the big wide world. I somehow knew, from a very early stage, that it was a cozy, protected bubble I was living in. Thus, I always imagined myself working and collaborating with people from various backgrounds and cultures, inspiring one another, and sharing knowledge and ideas on how to make the world a better place to live for everyone. The goal of improving people's lives and health—and, of course, an inherent sense of idealism and equity—has always been my main driving force. This inspired me to study medicine and ultimately led me to the field of neurology and epileptology, which quickly became my passion.


Epilepsy is a disabling and stigmatizing disease affecting more than 50 million people worldwide. However, more than 80% of people with epilepsy (PWE) are living in low- and middle-income countries (LMICs). One reason for this disproportional affliction of LMICs is the double burden of communicable (e.g. neurocysticercosis) and non-communicable causes of epilepsy (e.g. stroke). The rising tide of cerebrovascular disease and associated risk factors in LMICs will even worsen this already dire situation (read our blog article “The Rising Tide of Stroke in Tanzania” by Dr. Sarah Matuja). Epilepsy is accompanied by a 3-6 times greater risk of premature death, but if diagnosed and treated in a timely fashion, epilepsy can be well-controlled, resulting in seizure freedom in more than two-thirds of patients. In fact, an investment of only 5 USD per year can provide effective medication to help a person live seizure-free. Yet, >75% of PWE in LMICs remain undiagnosed or treated. Reasons for this considerable diagnostic and treatment gap include lack of awareness, societal misconceptions, insufficient capacity of the specialized neurological workforce, poverty, and poor access to anti-seizure medication.


Practicing in a large German university hospital, I feel more than privileged to benefit from the excellent expertise and resources needed for the diagnosis and treatment of epilepsy, including a wide range of safe, effective, and well-tolerated anti-seizure medication (ASM), MRI imaging, PET-CT scans, as well as invasive EEG-monitoring and epilepsy surgery. Most importantly, I can offer this expertise and technology to all of my patients without worrying about whether they can afford it. This situation is more than exceptional, considering the situation of PWE globally. During my daily practice, I often wish my colleagues and patients could realize and appreciate this fact. However, it sometimes seems quite difficult to overcome this “high-income bubble.”


As I am now trying to navigate my way, I also realize that the field of global health is changing. There obviously have been mistakes and malpractices concerning communication and collaboration between the Global North and the Global South in the past few decades. Fortunately, there is rising awareness of problematic structures like the "White Savior Complex," and the equal participation and partnership of local experts are regarded as essential for every global health project. Nevertheless, as a young white, female doctor from a high-income country, I sometimes find myself lost between the two extremes of a certain "postcolonial disinterest" of my high-income peer group on the one hand and "de-colonializing global health" on the other.


Yet, I am confident that our new generation has the potential to overcome these challenges and shape a new face of global cooperation in health, abiding by the guiding principles of equity and communication. I hope that young people stay open-minded and interested in global exchange, learning from one another, and making a difference together. For my work in global neurology and epileptology, I am looking forward to further creating clinical and scientific eye-level partnerships between Germany and the Global South (and North). The focus will be on globally improving access to and quality of neurological care, building neurological capacity, and taking advantage of new technologies (e.g. telemedicine). For the future of global health, aspects of prevention will also become more and more important. I am thankful and optimistic about the opportunity to collaborate and tackle these challenges together with many talented and enthusiastic people, such as the neurology team at the University Teaching Hospital in Lusaka, Zambia and the Global Neurology Working Group at the Center for Global Health at the Technical University in Munich.


As the new Chief Editor of the WNFO Blog, I am honored to support the foundation’s overarching mission of promoting neurological care and education in under-resourced regions. Together with my inspiring team members, Dr. Sarah Matuja from Tanzania and Dr. Jayant Yadav from Nepal, we hope to raise awareness about the increasing global burden of neurological conditions and the diagnostic and treatment gaps in different parts of the world. We envision our blog as a global platform highlighting diverse people, experiences, and voices in neurology along with fostering and promoting initiatives, projects, and accomplishments in the emerging field of global neurology.

 

If interested in supporting our blog efforts, please fill out this survey that will help further guide and shape the content of our blog.

 

Dr. Tamara Welte is a neurologist and epileptologist in training at the Epilepsy Center at the Department of Neurology at the University Hospital Erlangen, Germany. She is also part of the Global Neurology working group at the Center for Global Health at the Technical University of Munich. As a clinician and researcher, she has a keen interest in the global aspects of neurology and especially aims for the promotion of neurological care as well as neurological training and education in countries of need.





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