A perspective piece appearing today in the journal JAMA focuses on the challenges and opportunities arising from the increasing global incidence of neurological disorders. The authors advocate for new approaches that will increase access, lower costs, influence lifestyle changes, and create international research and clinical partnerships that address overlooked neurological conditions and underserved global populations.
The piece is authored by University of Rochester School of Medicine and Dentistry neurologists Gretchen Birbeck, M.D. and Robert Griggs, M.D., and Michael Hanna, M.D. with University College London. Birbeck is also member of the Epilepsy Care Team at Chikankata Hospital in Mazabuka, Zambia.
Demographic changes, namely an aging population, and the influence of infectious and chronic diseases is driving an unprecedented growth in disabling neurological disorders. Stroke is the leading cause of long-term disability and, in the developing world, causes more deaths than AIDS, tuberculosis, and malaria combined. The number of people living with dementia is expected to grow to 115 million by mid-century. In addition to these major disorders, there is a need to address more than 90 percent of neurological diseases that are considered “rare” and those that are unique to the developing world.
The authors point out that much of our current clinical understanding of neurological disorders is based on research conducted in developed populations. This leaves a significant portion of the world’s population – particularly those in low-income, tropical countries – underserved in terms of clinical research that focuses on neurological conditions unique to their region. This, coupled with a dearth of neurological expertise in these countries, is a barrier effective care.
The authors use the example of tropical epilepsy, which can be brought about by parasitic infection. While epilepsy is one of the most affordable diseases to effective treat, according the World Bank, 80 percent of the people who suffer from these seizures do not receive adequate treatment and research for this condition is essentially non-existent.
Birbeck and her colleagues contend that the U.S. must rethink its approach to funding research for neurological disorders and open the doors to international collaboration, address the regulatory burden that is a disincentive to progress, and develop training programs that ensure that the next generation of neuroscientists have the perspective and the skills to lead global research endeavors.