Editorial

Brain health, disability, and the need for broader thinking

According to WHO, disability is part of being human. throughout life, and in 2023 several steps have been taken

World Federation of Neurology/World Brain Day 2023

Around 1·3 billion people have a disability, with towards that goal. On May 27, 2023, the World Health
neurological disorders being the leading cause. Disabilities Assembly endorsed a resolution that calls for expansion
can affect people of every age, ethnic background, and and integration of rehabilitation services within health­
gender, yet people with disabilities still face many barriers, care systems and emphasises the importance of
including in access to health care. As highlighted by rehabilitation in primary care and emergency responses.
several new initiatives and publications, health officials, The third Global Rehabilitation 2030 meeting (Geneva,
health-care professionals, and the wider public all need Switzerland, held on July 10–11, 2023) saw the launch of
to do more to reduce the negative effects of disabilities several Rehabilitation 2030 resources, including a Package
associated with neurological disorders. of interventions for rehabilitation, which outlines essential For the WHO definition of
disability see https://www.who.
The theme of the tenth World Brain Day, held on rehabilitation interventions for 20 health conditions; int/health-topics/disability
July 22, 2023, was brain health and disability. World Brain the package includes a neurological disorders module For more on the burden of
Day has been organised annually since 2014 by the World that covers stroke, Parkinson’s disease, traumatic brain neurological disorders see
Articles Lancet Neurol 2019;
Federation of Neurology (WFN) and this year was run injury, spinal cord injury, cerebral palsy, and dementias, 18: 459–80
jointly with the World Federation of Neurorehabilitation and a developmental disorders module that covers For more on health equity for
people with disabilities see
(WFNR); together, these organisations want to increase autism spectrum disorders and disorders of intellectual
https://www.who.int/
awareness and reduce barriers to health care for people development. The meeting ended with the formal launch publications/i/
item/9789240063600
with neurological disabilities. The campaign has of the World Rehabilitation Alliance (WRA), a global
For more on World Brain
five aims: prevention (both of neurological disorders network of stakeholders (including WHO members, Day 2023 see https://
and of social and environmental factors that contribute governmental and non-governmental organisations, wfneurology.org/world-brain-
day-2023
to disability, such as stigma); awareness (of the effects philanthropic foundations, and academic institutions)
For more on the WFNR see
of neurological disabilities); access (calling for universal that aims to support implementation of Rehabilitation https://www.wfnr.co.uk/
access to diagnosis, treatment, rehabilitation, and 2030 through evidence-based advocacy. For more on global needs for
rehabilitation see Articles
assistive technology); education (of the public as well Improving access to rehabilitation is crucial but Lancet 2020; 396: 2006–17
as health-care professionals); and advocacy (to address other aspects of health care and perceptions also need For more on dysphagia after
discrimination, stressing that brain health is a human to change. For example, access to other types of care, stroke see Review page 858
For more on Rehabilitation 2030
right). As a key part of the campaign, a webinar entitled including palliative care, has to improve, and barriers see https://www.who.int/
Brain Health and Disability: Leave No One Behind featured to seeking care, including stigma, need to be removed. initiatives/rehabilitation-2030
powerful testimonies from people with neurological Health-care professionals, including neurologists, need For more on the resolution see
https://www.who.int/news/
disabilities and speakers from WHO and the WFN, WFNR, to be aware of patients’ needs and the social context of item/27-05-2023-landmark-
African Academy of Neurology, American Academy of disability, including to ensure that services are accessible resolution-on-strengthening-
rehabilitation-in-health-systems
Neurology, Asian and Oceanian Association of Neurology, to people with different mobility and communication
For more on the Global
European Academy of Neurology, Pan American needs. Health-care professionals also need to be sensitive Rehabilitation 2030 meeting
see https://www.who.int/news-
Federation of Neurological Societies, and Pan Arab Union to what their patients want and be mindful of the
room/events/detail/2023/07/10/
of Neurological Societies. disability paradox, whereby the clinician’s perception of default-calendar/3rd-global-
rehabilitation-2030-meeting
The aims of the World Brain Day 2023 campaign stress quality of life can differ from that of the patient.
For the package see https://
the need for rehabilitation. In 2019, 255 million people According to the World Brain Day website, “Brain www.who.int/publications/i/
were estimated to have neurological conditions that health is a human right that applies to everyone, item/9789240067097

would benefit from rehabilitation, most commonly everywhere”. Health officials, health-care professionals, For more on the WRA see
https://www.who.int/initiatives/
stroke, followed by dementias, cerebral palsy, and and the wider public can all do more to ensure that this world-rehabilitation-alliance
traumatic brain injury. For example, rehabilitation for right is realised for people with disabilities, not only by For more on action beyond
rehabilitation see
dysphagia after stroke is essential to reduce mortality and taking steps to prevent disabilities and improve access to Correspondence Lancet Neurol
improve patients’ quality of life. The WHO Rehabilitation treatment and rehabilitation, but also by changing their 2023; 22: 652

2030 initiative states that rehabilitation is an essential perceptions of neurological disabilities and the people For more on the need for
greater awareness see
health service that should be available for everyone who have them. ■ The Lancet Neurology In Context page 781

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