Original article by Johan A. Aarli published 16 September 2007 in World Neurology Vol 22 No. 3

In 1957, neuroscientists from many countries came together in Brussels on July 21 to 28 for the first Congrès International des Sciences Neurologiques (CISN). The Brussels congress was the sixth international congress of neurology. The first took place in Bern, Switzerland in 1931. Then followed London 1935, Copenhagen 1939, Paris 1949 and Lisbon 1953. The Brussels congress was not only the Sixth International Neurological Congress. It became the Fourth International Congress of Electroencephalography, the Third International Congress of Neuropathology, the First International Congress of Neurological Surgery and the fifth Reunion of the International League against Epilepsy (1).

During the preparatory meetings for the Brussels congress, Ludo van Bogaert had proposed that an international federation of neurological societies should now be organised. The idea was unanimously accepted and strongly supported and World Federation of Neurology was launched in 1957. Twenty-six delegates from 21 countries were present at the birth of the WFN. Ludo van Bogaert, who was the secretary-general of the congress, and Pearce Bailey were the prime movers. World Federation of Neurology thus grew from several international organizations. A meeting of electroencephalographers in London in 1947 had already led to the establishment of the International Federation of EEG and Clinical Neurophysiology. At a conference of this group and others in Moscow in 1958 there was unanimous support for a resolution proposing the creation of an international organization representing the whole of brain research. This plan was welcomed by UNESCO, and in 1960 IBRO was established.

Ludo van Bogaert (1957-1965) was elected the first president of WFN for the first two periods. WFN was organised as a federation of neurological societies which organized international congresses, formed research groups and edited World Neurology, which in 1964 was renamed The Journal of Neurological Sciences with Macdonald Critchley as an editor. Van Bogaert was the head of the Department of Internal medicine and Neurology at the Bunge Institute, and the Bunge Institute remained the location of the WFN during his presidency. Pearce Bailey was elected Secretary-Treasurer General.

Together with van Bogaert and Bailey, Georg Schaltenbrand (West Germany), Houston Merritt (USA), Macdonald Critchley and William McMenemy (UK) and Raymond Garcin (France) were central in the formative period of the organization. The National Institute of Health at Bethesda offered a grant of US$ 126,190 annually for five years in order to establish an office and to cover secretarial, postal, telephone and all other administrative and travel costs (2).

The founders of WFN hoped that a world-wide federation of national neurological societies would promote the dissemination of information and scientific knowledge, that it would foster collaborative programmes and that it would enable colleagues in the third world to promote high standards of neurological care and to develop improved services (2). This later was rewritten as "It shall be the purpose of the World Federation of Neurology to improve human health worldwide by promoting prevention and the care of persons with disorders of the entire nervous system by: Fostering the best standards of neurological practice; educating, in collaboration with neuroscience and other international public and private organisations; and facilitating research through its Research Groups and other means".

During van Bogart's presidency, it was decided that the delegates from the national neurological societies should meet towards the end of a world congress. The individual neurological societies were invited to come up with bids, and the venue for each congress was decided on the basis of the bids. A local organizing committee in the host country had then total freedom to organize the congress programme. This was changed in 1977, when it was decided that the WFN should assume responsibility for choosing the venue for the subsequent world congresses and the programme, in collaboration with the local organizing committee. The word International was substituted by World as the name of the congresses.

Macdonald Critchley (1965-1973) succeeded van Bogaert as president, with Henry Miller as the Secretary-General. John Walton became the new editor of the Journal of Neurological Sciences. Scientific Governance in the WFN had a long development. During van Bogart's presidency, "problem commissions" had been established. These commissions were to focus on topics of special importance for clinical neurology. The National Institute of Neurological Diseases and Blindness donated a grant of US$ 214,108 for a commission to work on the geographical pathology on cerebral vascular disease. Other problem commissions were established for a variety of neurological conditions, and they represented the research arm of the organization. Van Bogaert eventually proposed that the problem commissions should come under the aegis of a new organization called the World Association of Neurological Commissions with some contact with the WFN. He did so because he felt that, as the funding from the NIH for the WFN had run out, perhaps an independent research organisation might be better at fundraising. However, Macdonald Critchley had strong reservations about the new structure, as he took the view that removal of its research functions would emasculate the WFN. At a separate meeting in Geneva in 1966, it was agreed that instead of leaving the World Federation of Neurology, the problem commissions, now called Research Groups, should form a Research Committee with its own Chairman and Secretary-Treasurer General under the authority of the President and the Secretary-Treasurer General of the WFN (Walton, 1993). The first Chairman was Professor Franceschetti, with David Klein as and Secretary-Treasurer General. The idea was that each Research Group would in the future charge a subscription to the WFN. Unfortunately, fewer than half of the Research Groups ever paid their subscription.

Sigvald Refsum was elected the next President of the WFN at the World Congress of Neurology in Barcelona in 1973, and he also was re-elected for a second term four years later. In Refsum's time as President, John Walton was elected Chairman of the Research Committee. The WFN still suffered financial problems due to its insufficient income, and in 1977, a Finance Committee was established with George Bruyn as its Chairman. It was now proposed that each Research Group should attempt to raise funds for the support of their activities, of which 10 % would be paid to the WFN central funds.

For many years, the WFN Delegates at the Delegates meeting approved the programme of each World Congress before it was finalised. This became increasingly difficult with the passage of time but in both Vancouver and Buenos Aires the main themes were chosen by the delegates in consultation with the Research Committee and the local Scientific Committee. In London, one session that had been suggested by the Scientific Programme Committee was replaced by a different theme, creating a slight problem because of lack of pharmaceutical company interest in supporting it. Increasingly it had come to be recognised that the Scientific Programme Committee decided upon the topics and that the Council of Delegates could not really change them (2).

Richard Masland was elected President in 1981 during the World Congress of Neurology in Kyoto. James Toole was appointed Secretary-Treasurer General. Together, they took the initiative to publish World Neurology, an official newsletter of the WFN. George Bruyn, who was the Chairman of the Finance Committee, initiated an effort to improve the financial situation of WFN by establishing a sub-committee for Fund-Raising. That committee never came off the ground until 2004, in Jun Kimura's Presidency. Meantime, the WFN World Congress of Neurology in Hamburg revitalized the Federation's funds.

John Walton was elected President in Delhi in 1989 and re-elected together with the officers of the Federation in Vancouver in 1993. He was the last President to be elected for 2 periods. It was decided by the Council of Delegates in 1995 that the President from then on would be elected for one four-year period only, and that the First Vice President should no longer be Chairman of the Research Committee. Frank Clifford Rose was the Secretary-Treasurer General. Klaus Poeck remained as the First Vice-President. James Toole was the Editor-in-Chief of the Journal of Neurological Sciences.

During Lord Walton´s Presidency, in 1993, the World Health Organization convened an important meeting on Neurology in Public Health, where three goals were defined; (i) Neurology needs to be supported as a discipline and WHO can help in improving the position of neurology in the world; (ii) WHO can draw attention to neurological diseases; and (iii) WHO can promote a public health facet to the science of neurology.

During the period 1989-1997, several dramatic political events disturbed the world political situation; the Soviet Union broke down and a series of new countries now became members of the WFN. Previously, there had been a separate Research Group on Education, but it was decided in Vancouver to constitute a Continuing Education Committee, with Klaus Poeck as its first Chair. The Continuing Education Committee was charged with the responsibility of planning educational courses in association with future Regional and World Congresses. A new Committee on Public Relations was also established, with Don Paty as its first chair. Johan Aarli took over as Chair in 1995 because of Don Paty's illness.

In 1996, the World Federation was registered as a charity in the United Kingdom, so that its tax-exempt status was assured. The new status of WFN required constitutional changes in the Federation's committee structure and officers. These were presented to the Council of Delegates in Buenos Aires in 1997, and the modified version was accepted (3).

James Toole was elected President at the World Congress in Buenos Aires in 1997. The members of the Management Committee were now defined as Trustees with better defined responsibilities. The Research Committee invited the Management Committee to handle executive matters on its behalf. A permanent Secretariat was now established at Chandos Street, in a building adjoining to and owned by The Medical Society of London.

The offices of the Secretary-General and Treasurer were separated and Keith Newton came in as Administrator. Jun Kimura came in as the First Vice-President. Theodore Munsat was elected Chair of the Research Committee and Robert P. Lisak the Editor-in-Chief of Journal of Neurological Sciences. Ted Munsat, who also was Chair of the WFN Continuing Education Committee, implemented international programs of continuing education, using that of the American Academy of Neurology's Continuum as a model. According to the new Constitution, it was decided that the Council of Delegates from now on should meet annually (4).

In 1999, Jagjit Chopra took over as the Editor of World Neurology. James Toole organized an important Strategic planning meeting with the WFN Officers at Sopwell House outside London. The group agreed on recommendations for the WFN's future mission which were presented to and agreed by the Council of Delegates.

Several initiatives were taken by the new Management Committee. For the first time, WFN endorsement was defined. "Endorsement is based on prior submission of the programme's goals, speakers and topics, and differs from co-sponsorship which requires active participation by the WFN in the meeting's planning and execution, such as occurs with the World Congress of Neurology" (5).

Toole formed a World Federation of Neurology Foundation (WNFo) to take advantage of US tax laws to encourage charitable donations. This organization has grown over time to become an important part of WFN activities (6).

Jun Kimura was elected President at the London Congress in 2001. He was the first President elected from outside USA and Europe. During his period as First Vice President and Chair of the Constitution and Bye-Laws Committee, he put together, with legal assistance, the Constitution and Bye-Laws by which a registered charity under United Kingdom law can function as a worldwide organization. Johan Aarli was elected First Vice President and Richard Godwin-Austen continued as Secretary-General and Treasurer. Jun Kimura modified the Committee structure and decided that each Trustee should also chair a committee. Ted Munsat, who was the chair of the Education Committee, enforced the programs of continuing education, initiated during James Toole´s presidency and these developed into meaningful projects to help neurologists in developing countries despite shortage of funds.

During Kimura's Presidency, the discussion first arose whether World Neurology should appear only in electronic format, or continue in a paper version as it has done so far. It was decided to continue with the paper version and the electronic one. Johan Aarli, in his capacity as Chair of the Public Relations and WHO Liaison Committee, collaborated with the Department of Mental Health at the WHO in the preparation of the Neurology Atlas which was first published in 2004. The Atlas presented data from 109 countries spanning all six WHO regions and covered over 90% of the world population. The frequency of some neurological disorders, both in primary care and in specialist care was estimated, and the number of neurological beds compared. The Atlas gave data for number of neurologists, neurosurgeons, neuropaediatricians and neurological nurses as well as therapeutic drugs available in primary care and the level of subspecialized neurological services (neuroradiology, stroke centres, etc).

In Kimura's administration, it was also decided that Regional Directors (formerly Regional Vice Presidents) should be responsible for contact with the corresponding WHO office, be in close contact with the regional neurological association where it existed and that WFN should work to establish new regional neurological associations.

Johan A. Aarli was elected President of the World Federation of Neurology at the World Congress in Sydney 2005. He initiated the present Africa programme in close collaboration with the WHO.



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