Early Stages of Global Neurosurgery

Historic notes on WHO-WFNS and Bogotá Declaration


  • Walter D Johnson Professor of Surgery, Neurosurgery and Public Health Founding Director, Center for Global Surgery, Loma, Linda University
  • Andres Rubiano Neuroscience Institute, INUB-MEDITECH Research Group, El Bosque University, Bogotá, Colombia. ---- Neurological Surgery Service, Vallesalud Clinic, Cali, Colombia.
  • Enrique Osorio Department of Neurosurgery, LosCobos Medical Center, Colombia




The year 2015 was pivotal for the growth of global neurosurgery. In January, the United Nations (UN) adopted the Sustainable Development Goals (SDGs), replacing the expiring Millennial Development Goals. The SDGs were more comprehensive, having 17 Goals with 169 associated targets; a significant number of these included the necessity for surgical care to achieve the targets. 1

In early Spring 2015, publication of Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development - The Lancet Commission on Global Surgery created a paradigm shift in the understanding of surgical needs worldwide, particularly in access to safe, timely and affordable surgical care for billions of individuals and large gaps in global surgical health workforce.2  At around the same time, Disease Control Priorities 3rd Edition, Volume 1, Essential Surgery laid out the economic case for surgical care, particularly in low resource settings.3 In May, the 68th World Health Assembly unanimously approved WHA resolution 68.15 on strengthening emergency and essential surgical care as a component of universal health coverage.4  

The adoption of SDGs and WHA 68.15 provided the political impetus toward making surgical care a global priority, DCP3 created the health economic basis for global surgical care, and the Lancet Commission developed the factual needs basis for greatly enlarging global surgical service delivery.

The World Health Organization (WHO) is the health technical arm of the UN. The WHA is composed of the health ministers of all UN Member States (countries) and is the governing body of WHO, setting the global health agenda and steering WHO’s work. The WHO Emergency and Essential Surgical Care (EESC) Programme5 was given the mandate to implement WHA resolution 68.15; a task that could only be achieved through extensive worldwide partnerships, such as the World Federation of Neurosurgical Societies (WFNS), which has official working relations as a non-state actor with WHO.6

September 9-12, 2015, the 15th Interim Meeting of the World Federation of Neurosurgical Societies (WFNS) met in Rome, Italy.7 For the first time, a neurosurgeon was Lead of WHO EESC, creating a unique opportunity for optimally augmenting this WHO/WFNS partnership going forward. The Foundation for International Education in Neurosurgery (FIENS) held a session during this meeting, further highlighting future prospects.