Boston Declaration 2025

FEBRUARY TOWN HALL

A Landmark Event

• “Global Neurosurgery” has been defined as “the clinical and public health practice of neurosurgery with the primary purpose of ensuring timely, safe, and affordable neurosurgical care to all who need it.”
• The Boston Declaration aims to usher in the next era of global neurosurgery – by transforming thoughts into action and recognizing strong ongoing efforts
• Follows the Bogota Declaration in 2016: the first formal initiative to highlight deficits in neurosurgical care worldwide and appeal for building capacity for equitable care
• We aim to build upon this foundation, by expanding the global neurosurgical ecosystem and fostering collaboration and tangible, synergistic commitments

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What is the Boston Declaration?

• An unprecedented event in the field of global neurosurgery, taking place on April 24^th, 2025 from 4-6 PM EST at the historic Edward M. Kennedy Institute
• Celebration of collaboration, tangible commitments, and prioritized pledges to broaden global neurosurgical care
• To serve as a resource for other surgical subspecialties to chart a path forward towards global surgical care

What is the purpose of the Boston Declaration?

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• To call for a unified vision for the next phase of global neurosurgery
• To support the expansion of the global neurosurgical ecosystem beyond the neurosurgical workforce alone
• To urge action through tangible commitments and pledges from all major stakeholders 
• To foster a structure to lead a synergistic, bidirectional path forward through the coordination of action  and pledges

What is the Boston Declaration?

Process and Pledges

The Process

Our community needs to determine what our global needs and priorities are.

The Pledges

We aim to establish concrete commitments and prioritized pledges addressing specific global neurosurgical needs, with a focus on the countries previously identified as having insufficient neurosurgical workforce capacity.

We want to provide a platform for the extended ecosystem of global neurosurgery stakeholders to collaborate and collectively aim to broaden neurosurgical care worldwide. We hope you will join us in this historic endeavor!

PATIENT ADVOCACY ORGANIZATIONS

NEUROSURGICAL WORKFORCE

NEUROSURGICAL ORGANIZATIONS

ACADEMIC MEDICAL INSTITUTIONS

GOVERNMENT ORGANIZATIONS

NON-GOVERNMENTAL ORGANIZATIONS

INDUSTRY/PRIVATE SECTOR

INNOVATORS/

VENTURE CAPITALISTS

PHILANTHROPY

PREVENTION

January Town Halls: Key Takeaways

Challenges Highlighted: collated in country spreadsheet

• Barriers to equipment donations due to regulations, customs, and liability concerns
• Fragmented post-operative care within the US and challenges in sustaining neurosurgical services in LMICs
• Need to reconcile the divide between academic global neurosurgery and grassroot efforts 🡪 “Silos to Solutions”

Global Partnerships: strong emphasis on collaboration among global organizations; successful examples highlighted include Mongolia and Sierra Leone

Training and Workforce Development:

• Focus on neurosurgical training programs in Sub-Saharan Africa, the Philippines, Vietnam, and Sierra Leone
• Twinning programs have significantly increased workforce (eg: Duke-Uganda)
• Importance of multidisciplinary teams (bioengineers, ICU nurses, neurologists)

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January Town Halls: Key Takeaways

Funding and Financial Support:

• Emphasis on raising financial capital via government and industry partnerships
• Need for sustainable funding models

Research and Innovation:

• Research priorities discussed include TBI, stroke care, and epilepsy, although this is just the beginning
• Use of remote mentorship, VR/AR technologies, and mobile apps to support training and patient care

Commitments and Follow-Ups:

• Follow-ups will be done at 1, 3, and 5-year intervals
• Template and workflow for commitments/pledges to be sent out

Logistics:

• Working on opening registration spots specific to the Boston Declaration
• Social media campaign to increase visibility through media engagement

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Introduction to the global neurosurgical cause and the purpose of the Boston Declaration

Looking ahead…

Elucidating and characterizing specific areas of need

Drafting tangible commitments and pledges

Finalizing tangible commitments and pledges

Presentation of commitments and pledges at the Boston Declaration (April 24^th, 2025)

PROCESS

PLEDGES

SHOWTIME!

Introduction to the global neurosurgical cause and the purpose of the Boston Declaration

Looking ahead…

Elucidating and characterizing specific areas of need

Drafting tangible commitments and pledges

Finalizing tangible commitments and pledges

Presentation of commitments and pledges at the Boston Declaration (April 24^th, 2025)

PROCESS

PLEDGES

SHOWTIME!

Commitment/Pledge Framework

Resources

Engagement

Research & Development

Finances & Philanthropic support

Infrastructure & Equipment Support

Workforce Development & Education

Collaborative Networks & Ecosystem Expansion

Research &

Evidence Generation

Digital Health & Innovation

Policy & Advocacy

RESOURCES

Workforce Development & Education

• Neurosurgical training programs
• Fellowships
• Residencies
• Twin-twin programs
• Certification and accreditation pathways

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• Educational programs
• Faculty exchange
• Visiting professorships
• Remote mentorship

• Multidisciplinary training
• Neurosurgery
• Anesthesia
• Nursing
• ICU care

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• Priority training for Indigenous populations

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• Additional degree opportunities for global health leadership

RESOURCES

Infrastructure & Equipment Support

• Surgical Equipment

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• Surgical supply chain strengthening

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• LMIC engagement

• Sustainability programs for neurosurgical equipment and maintenance

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• Imaging and diagnostic infrastructure

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• Digital solutions for real-time access to neurosurgical tools

RESOURCES

Financial & Philanthropic Support

• Funding for neurosurgical innovations, training programs, hospitals, or NGOs
• Venture capital investment
• Corporate sponsorships

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• Global surgical center with earmarked funds for neurosurgical care

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• Long-term funding models
• Grants
• Endowments
• Public-private partnerships

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• Scholarships for LMIC trainees and early-career neurosurgeons

ENGAGEMENT

Policy & Advocacy

• Integration of neurosurgical services into national surgical plans

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• Inclusion of neurosurgical indicators in global health policies
• WHO
• UN
• Regional agencies

• Government engagement to fund neurosurgical services

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• Strengthening legal frameworks for international equipment donation

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• Advocacy for universal access to essential neurosurgical procedures

ENGAGEMENT

Collaborative Networks & Ecosystem Expansion

• Global neurosurgical think tanks and working groups

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• Standardized platforms for information sharing and best practices

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• Public-private partnerships for scaling neurosurgical initiatives

• Strengthen partnerships between high-income and low-resource settings

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• Interdisciplinary collaboration
• Bioengineers
• Neurologists
• Public health professionals

RESEARCH & DEVELOPMENT

Research & Evidence Generation

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• Collaborative multi-center research initiatives

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• AI-assisted surgical decision-making tools

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• National and/or global neurosurgical registries

• Prioritization of clinical and public health practice in LMICs
• Traumatic brain injury
• Stroke
• Epilepsy
• Hydrocephalus

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• Data collection on surgical outcomes and access gaps

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• Research fellowships

RESEARCH & DEVELOPMENT

Digital Health & Innovation

• AI-driven diagnostic and decision-making tools

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• Augmented and virtual reality for neurosurgical education

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• Telemedicine and virtual case consultations

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• Mobile applications for post-operative patient follow-up

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• Low-cost, scalable neurosurgical simulators

And what else?

Structure of Commitments/Pledges

What might a pledge look like?

WORKFORCE

Summary Statement: We pledge to train 10 neurosurgeons at XYZ program in [country] within five years, specifically by establishing a faculty exchange program. Through partnerships with international institutions, we will host visiting neurosurgeons for hands-on training, provide observerships for local trainees, and implement remote mentorship, ensuring measurable progress through accredited benchmarks.

S: Train 10 neurosurgeons at XYZ program in [country] through a structured and accredited training initiative.

M: Track progress using accredited program training benchmarks, including but not limited to case logs, in-service exams, and board exams.

A: Establish a faculty exchange program by partnering with international neurosurgical institutions to provide visiting faculty for hands-on training, mentorship, and curriculum development.

R: Leverage existing institutional partnerships and secure funding from global health organizations, professional societies, and/or government to ensure long-term success.

T: Successfully train 10 neurosurgeons by 5 years with at least 80% meeting training benchmarks and remaining in country.

Next Steps:

• For more examples of commitments and pledges in each category, please click here.
• Follow-up emails will be sent out with a link to…

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• this slide deck
• all town hall recordings
• the master country spreadsheet listing areas of need discussed during town halls
• commitment/pledge template, and
• instructions on submitting commitments/pledges.

• We will send out further registration and logistical information as soon as it becomes available.

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Next Steps:

ACTION ITEMS PRIOR TO MARCH TOWN HALLS:

• Please brainstorm any commitments or pledges you and your organization would like to consider. Please use the template as a guideline.
• The final deadline to submit final commitments and pledges will be March 16th. If you have any questions, please contact us at bostondeclaration2025@gmail.com.

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ACKNOWLEDGEMENTS

Scan QR code for direct link!

Thank you!

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If you have any questions or comments, please contact us at bostondeclaration2025@gmail.com

Scan QR code to register for the Boston Declaration

and a link to our website!