accumulated brain pathologies limit improvements; drugs are expensive and unscalable; and the number of symptomatic people increases as populations age. We need to change our approach. FIVE STRATEGIC OBJECTIVES The World Health Organization’s Intersectoral Global Action Plan on epilepsy and other neurological disorders provides a global plan for improving brain health worldwide. It has five strategic objectives: to raise policy prioritisation and strengthen governance; provide effective, timely and responsive diagnosis, treatment and care; implement strategies for promotion and prevention; foster research and innovation and strengthen information systems; and strengthen the public health approach. Ten global targets with measurable indicators will track the achievements by 2031. To reach these targets, the plan outlines close collaboration between stakeholders in the health sector and beyond, and the need to support the participation and empowerment of people with neurological disorders, their carers and families. The World Federation of Neurology together with other regional societies have developed their own plans. Several countries are also launching brain health strategies (including Italy, Finland, Norway and Switzerland). The European Academy of Neurology started the Brain Health Mission campaign to increase understanding and collaboration towards the final goal of the primary prevention of neurological disorders. It has established a leadership programme and forum with the European National Neurological Societies, as well as the Brain Health School Challenge and the Advocacy Training Programme. It also created a task force focused on the impact of climate and environmental changes on neurological disorders. EAN is also investigating the role of artificial intelligence in diagnosing and managing neurological disorders and is preparing new generations of medical students and neurologists for the next decade. The burden of neurological disorders is compounded by stigma and discrimination, hampering life opportunities, increasing poverty risk and creating difficulties in accessing care. Many neurological disorders are preventable, and much progress is being made in treatments and research. To achieve maximum uptake, health
information and interventions for disease prevention and improved health care should be directed towards the affected populations and developed collaboratively with the concerned communities implementing interventions tailored to local circumstances. AN ABYSS TO CROSS An abyss exists between what is being done and what needs to be done, and an abyss cannot be crossed in little steps. We need to be bold and adopt global, multi-level, pragmatic solutions to foster brain health throughout the life course, as advocated by the WHO. It defines brain health as “a state of brain functioning across cognitive, sensory, socio-emotional, behavioural and motor domains, allowing a person to realise their full potential over the life course, irrespective of the presence or absence of disorders”, which can be operationalised as “a state of optimal cerebral, mental, and social function in a safe, healthy, and supportive environment”. This definition is based on the WHO’s five determinants of brain health: physical health, healthy environment, safety and security, life-long learning and social connection, and access to quality services. Implementing brain health has to be simple enough that it can be followed by most people in most settings based on what is the least that yields the most: Activity and sleep, a Balanced diet and blood pressure control, and Connections that promote cerebral, mental and social function. High-level brain health plans require grassroots initiatives in actionable units, small enough to have a sense of community capable of connecting information with motivation and implementation. G7 leaders at the Apulia Summit can: 1.
VLADIMIR HACHINSKI Vladimir Hachinski is a professor of neurology and a scientist at Western University in London, Canada. He has made major contributions to the understanding,
diagnosis, treatment and prevention of stroke and dementia, most notably his concept of vascular cognitive impairment and the Hachinski ischemic score. He currently leads a multi-disciplinary team of experts in Western’s Community Integral Brain Health Initiative.
MATILDE LEONARDI
Matilde Leonardi is the director of the Neurology, Public Health, Disability Unit and Coma Research Centre at the Foundation
IRCCS Neurological Institute C Besta in Milan, where she also leads the Italian WHO-Collaborating Centre Research Branch. She is a board member and chair of the communication committee of the European Academy of Neurology.
ELENA MORO Elena Moro is a professor of neurology
at the Grenoble Alpes University
and coordinator of the department of neurology, psychiatry, forensic medicine
and neurological rehabilitation at the CHU of Grenoble. She is president-elect of the European Academy of Neurology.
declare life course brain health (neurological, mental, social) as a top priority; coordinate, integrate and catalyse brain and mental health policies; and link global, regional and national brain health plans and energise them to implement a One Health approach with brain health at the centre of healthcare systems, policies and interventions.
PAUL BOON Paul Boon is a senior full professor and director of neuroscience at Ghent University, where he is also chair of the Division of Head, Movement and Senses. He also teaches
2.
3.
neuromodulation at Eindhoven University of Technology, and is the president of the European Academy of Neurology.
If only 10% of people change their mindset, changes follow quickly. We all need to change our own mindsets from tackling problems to preventing them.
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globalgovernanceproject.org
2024 — G7 ITALY: THE APULIA SUMMIT
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