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AANS Neurosurgeon | Volume 27, Number 1, 2018

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Member Spotlight: Gail L. Rosseau, MD, FAANS

Reporting from the World Health Assembly in Geneva

The Seventy-first World Health Assembly took place May 20-28, 2018, in Geneva and nearly 20 neurosurgeons attended. The World Health Assembly (WHA) is the decision-making body of the World Health Organization (WHO). Among those in attendance, representing the World Federation of Neurosurgical Societies (WFNS) was WFNS-WHO Liaison Committee Chair Gail Rosseau, MD, FAANS. Dr. Rosseau also served as vice president of the American Association of Neurological Surgeons (AANS), 2014-2015. Here, she shares information about the WHA and the importance of neurosurgical advocacy at the international level.

AANS Neurosurgeon (AN): What are the current activities and goals of the WFNS-WHO Committee and how were these advanced at the most recent World Health Assembly?

Gail Rosseau, MD (GR): The goal of the WFNS-WHO Liaison Committee is to advance the mission of the WFNS, which is to promote global improvement in neurosurgical care. The WFNS mission is accomplished by working with WFNS member societies to improve worldwide neurosurgical care, training and research to benefit our patients. The special role of the WFNS-WHO Liaison Committee is to focus on the global presence and influence of the WHO as a means to support, coordinate and promote these neurosurgical efforts. 

The WHO works with 194 member states, across six regions to promote better health for all, globally.. The WFNS-WHO Liaison Committee has ongoing communications with the WHO agencies that coordinate various aspects of WHO activities, as they relate to neurosurgery. This includes emergency and essential surgery, trauma prevention, stroke prevention, rehabilitation pediatric care and tumor management. 

The WHA takes place every May, in Geneva. This is the annual meeting of the Ministers of Health of the Member States of the United Nations. The WHA is the largest meeting of the year for WHO.  The goal of the meeting is to review, plan and approve the agenda of the WHO. During the one-week meeting, countries agree to resolutions, approve budgets, discuss key public health issues and determine policy.

Each United Nations (UN) Member State has one vote, usually cast by their Minister of Health. The meeting draws several thousand participants, including health professionals, patient advocates and industry partners. Many Non-Governmental Organizations (NGOs), such as the WFNS, are in official relations with the WHO, providing an opportunity for their representatives to monitor reports and voting, and to make statements during the proceedings.

AN: Can you explain the WHA Resolution 68.15 and its importance to neurosurgeons globally?

GR: Initially convened in 1948, the WHA meeting has increased in importance to neurosurgeons since the 2015 adoption of WHA Resolution 68.15, which strengthens the commitment of WHO to the Global Initiative for Emergency and Essential Surgery (GIEES)1. Neurosurgeon Walter Johnson, MD, FAANS(L), now works full-time in Geneva as Program Lead for GIEES. The specialties largely based in operating rooms (i.e. surgery, obstetrics, trauma and anesthesia) were responsible for the introduction of this resolution, which was approved unanimously. These disciplines are now working together, at WHA and throughout the year, to advance access to surgical care as a human right. The publication of the Lancet Commission Report on Global Surgery successfully presented the economic case for 44 Bellwether procedures to be widely available and laid out a framework for progress on a global scale.2

AN: What does the data collection in member states for the 2019 report hope to demonstrate about neurosurgical care in particular or surgical care in general?

GR: For many nations, the required reporting at WHA 2019 will be the first time a coordinated review of surgical services delivery has ever been done. Even in developed nations, there will be important information made available about distribution and quality of services. This may lead to real improvements in training of specialists and in specialty care.

The adoption of the WHO Surgical Safety Checklist, for example, was established in 2009 to reduce surgical morbidity by 35 percent and mortality by 47 percent, saving more lives than vaccinations. With publication of these results, the British National Health Service immediately adopted its universal use.3


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AN: Have you seen progress made because of neurosurgical advocacy efforts before the World Health Assembly?

GR: The strong and growing neurosurgical presence at the 71st WHA firmly positioned neurosurgeons to be key partners in the scaling up of emergency and essential care and anesthesia in the developing world. Neurosurgeons are working closely with our allies to spread advocacy campaigns, design policies to improve surgical care delivery and help set the global health agenda so that neurosurgical patients everywhere will have access to the best possible neurosurgical care.4

AN: What motivated you to get involved in global advocacy and volunteering?

GR: I have always been interested in how our colleagues around the world practice our craft: what are their struggles and barriers, as well as what we can learn from practice carried out in a different environment. As the world has become “flat,” good ideas that advance our profession are increasingly coming from abroad. This includes systems for training and delivery of care. As the world also becomes “smaller,” the challenges of inadequate access to health care in some parts of the world become more evident.

I believe in that saying, “From those to whom much is given, much is expected.” Most American neurosurgeons have abundant lives, and the capacity to give back. We are the first generation in the history of civilization that is likely to have health and resources at the time we retire from neurosurgery. There is much work to be done by those neurosurgeons who still wish to contribute to global neurosurgery, as their own clinical responsibilities at home are reduced.

AN: Do you have advice for neurosurgeons looking to advocate internationally for the field?

GR: Yes, get involved! The WFNS-WHO Liaison Committee is open to all neurosurgeons who are members of WFNS member societies. The AANS also has robust international activities. The Foundation for International Education in Neurosurgery (FIENS) and ThinkFirst are both active internationally. There has never been a better time to get involved in Global Neurosurgery!

References

1. World Health Organization (2015). Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage.

2. Meara, J. G., Leather, A. J., Hagander, L., Alkire, B. C., Alonso, N., Ameh, E. A., . . . Yip, W. (2015). Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. The Lancet, 386(9993), 569-624.

3. Gawande, A. (2018, May 21). Personal Interview.

4. Rosseau, G.L. (2018). Report to Neurosurgeons on the World Health Assembly (WHA).

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