World Federation of Neurology 50 years: Heritage shapes the future

Neurology was a major topic at the 17th World Congress of Medicine, which was held in London in August 1913. Joseph Babinski lectured about cerebellar symptoms, Gordon Holmes on thalamic symptoms, Jules Dejerine on motor aphasia and Herrmann Oppenheim on myopathic disorders. But the London Congress of Medicine became the last of its kind. From then on, the international congresses became more specialized.

One international congress of Psychiatry, Neurology and Psycho logy had already been organised, in Amsterdam 1907. The second was held in Bern in 1931, the next in London 1935, Copenhagen 1939, Paris 1949 and in Lisbon in 1953 ⁽¹⁾. The First International Congress of the Neurological Sciences was held in Brussels in 1957, and it was during that congress that the World Federation of Neurology was founded ^(1,2).

The Brussels congress was a joint meeting for neurology, neurosurgery, and neuroradiology and of the International League against Epilepsy. An invitation had been sent in advance to neurological societies throughout the world to send a delegate to an organisational meeting to be held during the congress. At that meeting, the World Federation of Neurology was formed. Ludo van Bogaert was elected the first President, but Houston Merritt and Pearce Bailey were important powers behind the establishment of the World Federation of Neurology. A grant of US$ 126,190 annually for five years from NIH was essential in order to get the organisation started.

The history of the World Federation of Neurology has been described in recent publications ^{(2, 3)}, and will not be repeated here. Instead, I will try to delineate how the social and scientific development over the last 50 years has influenced its evolution. The winds of change have also swept over neurology. The World Federation of Neurology was created to develop international and interdisciplinary research projects in the neurosciences. Neurological research has now become international, and a global network exists between universities and research institutions. One important mission of the World Federation of Neurology is to implement international congresses of neurology. The quadrennial meetings of the World Congresses of Neurology now serve as the most effective venue for presenting scientific achievements and interacting with delegates of varied backgrounds and perspectives.

Regional neurological organisations have been established, most of them with a well developed infrastructure, with annual meetings allowing for strong personal and scientific ties across boundaries. They now have the opportunity to collaborate with the regional and national levels of WHO to ensure implementation of "health-forall" strategies at their level. Each professional neurological association may initiate and assist in the identification of areas where there exists a need for campaigns aimed at the prevention of neurological disease.

The prime intention behind organising an international federation of the national neurological associations was not only to promote international collaboration in research, but also to promote standards of neurological care in developing countries, enabling neurologists in developed countries to assist their colleagues in places with fewer resources to promote high standards of neurological care and to develop improved services ⁽²⁾.

The main conclusion from the Neurology Atlas, published by the World Health Organization (WHO) and the World Federation of Neurology in 2005, is that the available resources for neurological disorders in most countries of the world are insufficient compared with the known significant burden associated with these disorders, and that the situation is worst for Africa. Only half of the responding countries in Africa have a national neurological association and some of them do not have a single neurologist. To the World Federation of Neurology, the development of neurology in Africa is therefore a leading vision. The national health authorities in each country correspond with WHO, not with World Federation of Neurology. The World Federation of Neurology has now developed a close co-operation with WHO within the context of global health issues as identified by WHO. Appropriate strategies for the prevention and control of non-communicable and communicable neurological diseases should be part of clinical neurology. If World Federation of Neurology wants to convince health planners to give brain disorders a higher priority, we have to work through the WHO. Our goal is to develop standards of neurological care in developing countries, partly through the WHO, and partly as a direct mission.

The mission of our Research Committee, chaired by Roger Rosenberg, is to improve the health of patients with neurological disease, particularly in developing countries, through the formation and support of international Research Groups, many of them with their own journals and own scientific congresses. The Research Groups also serve by exchange of views and information and by advising the Organising Committee for each World Congress of Neurology. The Research Committee has also launched new initiatives to disseminate up-to-date information on recent advances in therapy. Entitled "Research Advances in Neurology", this section of the WFN website covers current research advances in clinical and basic neuroscience in areas of various research groups. These reviews emphasize neurotherapeutics, including those treatments available and affordable in developing countries. They are intended to provide neurologists everywhere with an electronic syllabus on important new therapies that will be up-dated every six months.

The Education Committee, chaired by Ted Munsat, also focuses on global concerns and advocates implementing programmes for the improved care of patients with neurological disorders through the education of physicians worldwide. The Education Committee encourages and assists in the education of young neurologists in the hope of improving patient care where needed ⁽⁴⁾. An important part of the mission of the World Federation of Neurology is the Continuous Medical Education Programme, conducted with national neurological societies utilizing group discussions of Continuum, generously donated by the American Academy of Neurology, and Seminars in Clinical Neurology that the World Federation of Neurology publishes periodically. The World Federation of Neurology has expanded from 21 countries in 1957, to 96 member countries in 2007. When neurology is established in more African countries, and neurology can cross borders, the World Federation of Neurology will become a true global organisation.

Literature

1. Poser CM. The World Federation of Neurology: the formative period 1955-1961. Personal recollections. J Neurol Sci 1993;120:218-227.
2. Walton J. The World Federation of Neurology. Pp 573-588 in. The Spice of Life. From Northumbria to World Neurology. Roy Soc Med Services, London 1993.
3. Aarli J.A. World Federation of Neurology. J Neur Sci 2007 (in press)
4. Bergen DC. Training and distribution of neurologists worldwide. J Neurol Sci 2002;198: 3-7.

At time of publication Johan A. Aarli was President of the World Federation of Neurology