Letter: Functional Neurosurgery—A Neglected Aspect of Global Neurosurgery: Call to Action

To the Editor: The leadership of the World Society for Stereotactic and Functional Neurosurgery (WSSFN) read with interest the recently published letter “Functional Neurosurgery—A Neglected Aspect of Global Neurosurgery: Call to Action” by Kundu et al.1 We do agree with the authors that the development of functional neurosurgery in low- and middle-income countries (LMICs) poses a challenge and is of the highest importance considering the growing need. There are about 50 000 neurosurgeons worldwide, but far from evenly distributed. There is further an unmet need, and it is estimated that 23 000 additional neurosurgeons would be needed simply to cover an additional 5 000 000 procedures that should be performed each year.2 This unmet need is of course larger in LMICs and, in relative terms, probably more pronounced regarding functional procedures.3 WSSFN is fully aware of this global challenge and has an agenda that addresses it in a number of ways: To achieve a truly global reach, the WSSFN has recently created a mutual benefit program with a closer collaboration with continental and regional societies such as the Indian, Chinese, Middle Eastern, South American, and many other societies for stereotactic and functional neurosurgery. With this initiative, the members of the associated societies have become WSSFN members, allowing them to gain full access to our educational resources (including our journal Stereotactic and Functional Neurosurgery) and network. Many educational activities, courses and symposia, are regularly undertaken by the associated societies, and WSSFN supports education in its own capacity. We are providing travel grants and training workshops at the premier world gatherings in stereotactic and functional neurosurgery, including those at our biannual congresses (https://wssfn2024.org) and interim meetings (https://wssfn2023.com), offering the attendees a wide spectrum of educational activities. Our society is also directly endorsing a number of courses, often aimed at LMICs (https://www.cadavercourse.org). We have been providing free educational webinars (https://www.wssfn.org/webinars) by leading experts, and more than 25 courses and 250 lectures covering virtually every aspect of clinical importance in stereotactic surgery are available free of charge at the Stereotactic Academy (https://www.stereotactic.org), some of which are translated to other languages with the specific intent of overcoming the often significant language barriers. Perhaps even more importantly, the WSSFN is providing a worldwide meeting ground. Our committees and task forces are working to establish consensus on a global scale and practical guidelines that might be of great value at a local level.4 Furthermore, our events enable the personal meetings between colleagues from different parts of the world, which are often of crucial importance to create successful collaboration between high-income countries and LMICs. Moreover, WSSFN members actively participate in mentorship initiatives by our sister societies (eg, the International Neuromodulation Society—www.neuromodulation.com) that provide one-on-one collaboration between individually linked established neurosurgeons and younger trainees and aspiring practitioners. However, with that said, it is evident that much remains to be done at a global level and that development of functional neurosurgery in LMIC poses a huge educational—and logistical—challenge. The work of WSSFN and our associated societies is based on volunteering by our members. Hence, to increase the focus on training activities, capacity building, and productive collaboration in LMICs, we would like to encourage everyone interested in this field, especially those from LMICs, to join and get involved in local stereotactic and functional neurosurgery societies, or WSSFN directly, and to work with us to meet this challenge.

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