Call to Action: Putting Brain Health on the Global Agenda

This is a summary of the call to action emerging from the Brain Health and Research Day at UNGA78.

In a time of increased attention on international health crises, we cannot ignore the pandemics that are all around us: the growing prevalence of noncommunicable diseases accounts for a staggering 74% of all deaths globally.

Brain disorders — encompassing neurological diseases and disorders and mental illnesses — are widespread, disabling and difficult to treat. These include a range of conditions: epilepsy, depression, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, depression, stroke, schizophrenia, headache, anxiety disorders, chronic pain as well as rarer brain disorders like amyotrophic lateral sclerosis (ALS), dystonia, and ataxia. In fact, it is estimated that worldwide up to 1 billion people live with a neurological condition and 970 million people were living with a mental health disorder as of 2019, with anxiety and depressive disorders the most common.

These alarming numbers predate the COVID-19 pandemic, which we now know led to higher rates of mental health conditions — COVID-19 also triggered neurological complications. These statistics represent a high individual, social, and economic burden and contribute to the global disease burden and disability.

However, the main reason for improving brain health is not to address a perceived burden. It is to allow people to thrive — to live in health and in happiness, to power our labor markets and economies, and to build for future generations. Instead of seeking to avoid extra cost, policymakers and society at large should view the prioritization and support of brain research as an investment into prevention, wellness, and optimization; thus, creating a better future for every citizen of the world. As The Lancet Neurology noted in their editorial on this event, sustainable development demands brain health.  

We are still far from having a complete understanding of how the brain functions as a system and how it is impacted by the rest of the human system and the external environment. However, advances in science and technology, and global commitments to greater collaboration and coordination, have created pathways for accelerating progress.

Priorities to Address Brain Disease and Improve Brain Health

To address the burden of brain disease and improve brain health in the future, these are the priorities:

Address the unmet needs of patients. What’s needed: 1) more research on early diagnosis and opportunities to integrate mental and brain health risk detection, 2) establishment of treatment protocols for use in primary and pediatric healthcare settings, 3) expansion of the workforce to include nonclinical healthcare workers to help detect risk early, treat mild conditions and improve population health and wellbeing.

Learn from health crises such as COVID-19. We need to rethink health systems and designs to improve population health and ensure we are better equipped for the future. This will require a paradigm shift for health systems, moving from a hospital-centric focus and a disease specific approach to integrated, multidisciplinary coordinated care, including health promotion and prevention strategies that address health determinants and relevant risk factors.

Go beyond the traditional recommendations and targets, working toward a new normal that addresses the health care system pitfalls of the past. We need to interlink health, welfare and economics while addressing unmet needs and diagnostic and treatment gaps, as well as economic and organizational challenges.

Develop and deploy a strategic research and innovation agenda at all levels — local, regional, and global — with the aim of providing recommendations on future areas for excellent, innovative, and translational research. This will require stronger engagement and alignment with decisionmakers, regulators, and payers, encouraging greater understanding of the brain and its disorders and improving patient outcomes.

Develop validated metrics and tools to measure brain health across the lifespan, by integrating existing data and addressing gaps in data collection in worldwide.

We call on the United Nations and Member States to:

• Recognize brain health as an urgent priority in making global action plans. There is no health without brain health, and we must expand on the current goals for healthy lives and well-being for everyone, at all ages, to factor in noncommunicable diseases (NCDs). Furthermore, access to health care and treatment should be viewed as a priority in the fight against the growing burden of brain disorders and other NCDs.
• Recognize pronounced disparities in brain health research, care, and infrastructure across regions and foster the establishment of national brain plans at Member State level. These plans must be supported by policymakers and society as a whole, so that countries can run a concerted national strategy to maintain health and combat brain diseases throughout the human lifespan.
• Encourage inclusive, equitable and supportive frameworks for research collaboration at the international level and foster participation and inclusion from all regions in project leadership, access to data and funding, infrastructure, and capacity building. This should include targeted support — financial, infrastructural, and educational — for regions that are lagging, so they can leverage these recommendations effectively.
• Place health and science at the forefront of the Summit of the Future in 2024 and post-Sustainable Development Goals strategies by recognizing the vital role and contribution of science to reaching the United Nations Sustainable Development Goals and spearheading the development and launch of science collaborations across the Global North and South to tackle global public health issues.