We, the Japanese Society of Neurology (JSN), would like to host the 23rd World Congress of Neurology in 2017 in Kyoto.

Founded originally in 1902, the JSN has evolved into a large society with its members topping 8,852 in the past 50 years particularly after its separation, in 1959, from the original society where both neurologists and psychiatrists were members.

During those years, Japan has developed superior human resources in a broad range of neurological subspecialty fields and conducted world-class high-quality research, primarily through cooperation with the World Federation of Neurology (WFN) as well as the Asian and Oceanian Association of Neurology (AOAN). In 1961, two years after the establishment of the current JSN, the AOAN was established through the leadership of our founders and its first meeting, the Asian and Oceanian Congress of Neurology (AOCN), was held in Tokyo in 1962. Moreover, in 1975, Japan launched a system to certify qualified specialists in neurology and has since then produced more than 4,866 board certified neurologists and 2,403 senior fellows.

With this system in place, Japan has built a rich environment to nurture its neurologists. With all this in mind, we are proud to say that the Japanese Society of Neurology has been continuously putting its best efforts to advance research, education and medical practice to a level at par with the best international standards.

The Kyoto WCN meeting in 1981 greatly contributed to the development of JSN and AOAN. Along with international cooperation and the achievements of the past 30 years, Japan is determined to make the WCN 2017 another historic meeting that will serve as a springboard to advance the Asia Initiative of the WFN for the worldwide advancement of neurology in both scientific and clinical aspects. In particular, we would like to focus on three issues in WCN 2017. First, the environment and an aging society are urgent global issues that need to be addressed, especially by the rapidly developing economies of the Asian and Oceanian regions. The Japanese Society of Neurology is in a position to contribute greatly in solving the above based on its experience in overcoming similar issues, as has been seen in its measures in controlling Minamata disease, sub-acute myelo-optico-neuropathy (SMON) and in battling dementia.

Second, Japan is a suitable place to share information and discuss the international cooperation related to neurological medical services in the disaster. Japan experienced not only the Great East Japan Earthquake but also the tsunami and nuclear disaster in March 2011, and has been recovering from the triple disasters thanks to the generous support from all over the world. We would like to discuss the role of neurology in disaster medicine as well as express our gratitude to all the countries that kindly helped us.

Third, as a country with a high standard of neurological service and research, exemplified by the establishment of induced pluripotent stem (iPS) cells and brain machine interfaces (BMI), Japan would be an excellent place to share information on highly efficient neurological medical services as well as results of state-of-the-art studies with our international colleagues, especially those in the Asian and Oceanian region.

Kyoto, famous for its rich history and culture, is a major part of Kyoto-Osaka-Kobe metropolitan area located in the central part of the main island of Japan. A former imperial capital with more than 1,200 years of history, Kyoto is a living museum with a fifth of Japan’s registered national treasures along with 17 UNESCO World Heritage sites, unmatched anywhere else in the world. In addition, Kyoto is a renowned center for its world-class sciences bearing fruit to many Nobel laureates including Shinya Yamanaka, who was awarded with the Nobel Prize for Physiology or Medicine in 2012. His discovery of iPS cells started a revolution in stem cell research not only in neurodegenerative disorders but also in other fields of medicine. Kyoto residents are renowned for their hospitality. Outstanding service can be expected wherever you go, be it meeting venues, hotels, restaurants or enchanting cobbled lanes, you will be welcomed with all the warmth of the cultural heart of Japan. In addition, because of Japan’s reputation for being a friendly and safe place for travelers, tourists feel comfortable traveling alone in the city at any hour of the day.

For the WCN 2017, the Japanese Society of Neurology looks forward to welcoming you to Kyoto, where you can experience the very essence of Japanese traditional and modern culture as well as the major breakthroughs and developments in the field of neurology.

Since its establishment in 1982, the Korean Neurological Association (KNA) has demonstrated stable growth over the last three decades, and a lot of effort has been made to take the KNA to a global level. (For more, see “Changing Face of KNA” in Neurology 2013;80:1145-1147). Keeping up with the 30th anniversary of the KNA in November 2012, the KNA is currently preparing to make a new leap forward by planning to host WCN 2017 in Seoul.

The members of the KNA strongly believe that hosting the event for the first time in Korea can be meaningful since it will be a great opportunity for them to thank those who helped end the Korean War 60 years ago. It will be amazing for all our professional colleagues to see the unprecedented progress that Korea has made over the last six decades. Furthermore, it will be truly uplifting for those colleagues whose ancestors actually helped us during the war as they see the amazing impact that their sacrifices have brought to all Koreans. This is the reason that the KNA is so eager to host WCN 2017.

Foundation, Development of KNA

The KNA had a late start as an independent branch of the Korean Medical Association due to a rigid medical board system led by the government that did not easily permit the existence of an independent neurologic association. Through many struggles with other related fields, however, the KNA became a separate entity as an official independent academic association in 1982. The following year, the KNA began issuing the Journal of KNA. In 2005, the KNA began to issue a separate English journal, the Journal of Clinical Neurology (JCN; http://thejcn.com/) to help international readers. The JCN is published quarterly and is indexed in the SCI-E (impact factor in 2012: 1.892). In 1996, the KNA successfully held its first international conference, the Ninth Asian and Oceania Congress of Neurology (AOCN). Inspired by this success, KNA members have become more actively involved in international academic societies. Over the last decades, the KNA has made numerous achievements in the development of the fields of neurology and neuroscience, and has contributed to public health as well.

Current Activities of KNA in Korea

The number of total residents and board-certified members in neurology in Korea increased sharply to about 1,800 members. Since the late 1990s, the KNA has facilitated the establishment of diverse subspecialty societies, and has actively expanded academic exchanges with other countries. Starting with the Korean Epilepsy Society in 1996, 14 subspecialty societies have been founded.

International Activities

One of the major activities of the KNA is international collaboration. The KNA has been putting much effort to build relationships and tighten the ties between Korean neurology and other parts of the world. The KNA has been participating in the East Asian Neurology Forum to share academic knowledge and regional concerns with the neurologic societies of Japan and Taiwan. Along with the Ninth AOCN in 1996, which was the first international academic meeting hosted by the KNA, the Ninth World Congress on Sleep Apnea (WCSA 2009), organized by the Korean Society of Sleep Medicine, and the Seventh World Stroke Congress (WSC 2010), organized by the Korean Stroke Society, were landmark events that strengthened the international network.

Why Seoul as Host for WCN 2017?

Active support from the Korean Government

The Korea Tourism Organization (KTO) and Seoul Tourism Organization (STO) will provide both financial and promotional supports to WCN 2017 to be held in Seoul. The Korean Government, including the Seoul Metropolitan City, sincerely welcomes the World Congress of Neurology and looks forward to meeting the members in Seoul, South Korea, in 2017.

The KNA has extensive experiences in hosting international congresses

Recently, the KNA has successfully hosted many international congresses in diverse fields of neurology. These experiences will certainly help make WCN 2017 a great success.

Providing opportunities for contribution  to WFN to new members

By helping the KNA to host WCN for the first time, all members will be inspired by an equal opportunity policy that the WFN pursues in making contributions to the society.

Special considerations provided to  participants from developing countries

Diverse academic and financial support programs are available for participants from the developing countries in regards to registration fees, accommodations and travel grants.

Convenience during the whole stay  from arrival to departure

The award-winning airport, comfortable accommodations, go-anywhere transportation, attractive places to see, convenient shopping and more create a most memorable trip for all participants.

See, Hear, Feel Korea

Korea offers an abundance of activities and festivals including Temple stay, DMZ tours, traditional SPAs, which are only available in Korea. Korea, with the 5,000-year history embraces the cosmopolitan flair of modern cities. Korean history stretches back thousands of years, and its culture is rich, complex and totally unique. Various palaces, fortresses, gates, museums and monuments are located all over Seoul, allowing visitors to experience the rich historical assets first hand.

Above all, the enthusiasm of KNA for the WCN 2017

Despite aforementioned advantages, nothing can be more important than the enthusiasm of Korean neurologists in hosting this glorious congress for the neurologists from all over the world. We believe that our enthusiasm for hosting the WCN 2017 in Korea will be the main key for the success of the WCN 2017.

As the new editor-in-chief of the Journal of the Neurological Sciences (JNS), I would like to introduce the readers of World Neurology Online to some new features for the journal. The first and most obvious change is a new “face” or cover for JNS. The new cover is more abstract to reflect the modern global era. The design team at Elsevier is also making the journal website more intuitive with easy links to the websites for the World Federation of Neurology (WFN) and World Neurology Online.

To fulfill its mission as the official journal of the WFN, JNS will continue to publish the best original articles in neurology and neuroscience from around the world. In addition, new areas of special interest, each with a new associate editor, have been added. These new areas and associate editors are “Best Practices” (Carmel Armon), “Global Neurology” (Donald Silberberg), “Basic and Translational Sciences” (Nicolas Bazan), “Outcomes Research” (Bruce Ovbiagele) and “Reviews, Commentaries and Editorials” (Daniel Truong). JNS also has a new editorial board, which is comprised of internationally recognized experts in neurology and neuroscience from around the world.

Working with the publishing team at Elsevier, JNS is committed to serving the members of the WFN and strengthening our ties with the World Congress of Neurology (WCN). As such, we will publish the WCN-2013 abstracts as part of the September 2013 issue. Because JNS has a tremendous global reach and readership, we believe that this issue will be an excellent vehicle to communicate the new and exciting developments that will be presented at WCN-2013 in Vienna.

Also, Vladimir Hachinski, the president of WFN, and I will be convening a teaching course, “How to Get Published in International Journals” Sept. 23 at the WCN-2013. We believe that this course, which will highlight the new priorities of JNS, will be of interest to many WFN members.

JNS is offering a new service called AudioSlides. This feature offers authors of an accepted article the opportunity to include a five-minute presentation (PowerPoint or PDF) with their publications. As the name indicates, the presentation includes audio and slides prepared by the authors and available online at ScienceDirect under an Open Access license. Authors can easily assemble the presentation by using an Elsevier-provided website. We believe that this added feature will be of great benefit to both authors and readers.

The editorial team and I also are exploring ways to provide additional educational programs through the journal. We intend to offer CME-accredited opportunities by linking the JNS website to selected educational activities. Many of these activities will contain multimedia content, including videos. We are also working toward providing CME-credits through selected articles in the journal.

All of us on the editorial team of JNS look forward to serving the WFN by increasing the prominence and circulation of the journal. We are committed to playing a vital role in addressing the challenges in global neurology and educating neuroscientists, neurologists and allied health care professionals around the world.

Jori Fleisher, MD

The past several decades have seen a groundswell of interest in the practice of neurology in low- and middle-income countries. As established clinicians, researchers and groups such as the World Federation of Neurology, American Academy of Neurology and the European Federation of Neurological Societies (EFNS) turn their attention to improving the care of neurology patients around the globe, tremendous opportunities for international collaborations have arisen. Even more recently, our specialty has seen a rise in individual efforts, or “bottom-up” approaches to global involvement, with the impetus frequently coming from trainees.

The unification of organizational interests with the growing demand for international opportunities by trainees could not come at a more opportune time. Currently, neurologic disorders account for more than 8.7 percent of premature deaths and years lived with disability worldwide.1 Stroke alone accounts for 4.1 percent of all disability-adjusted life years (DALYs), followed by Alzheimer’s disease and other

Sarah Wahlster, MD

dementias, epilepsy, migraine, Parkinson’s disease, CNS infections and neoplasms. Importantly, these estimates do not include traumatic brain injury, a major cause of premature death and disability particularly in rapidly developing nations. Such statistics take on even greater urgency in light of the dearth of neurologists in low- and middle-income countries. In one study, 23 African nations averaged one neurologist per 5 million population, with 12 countries having none.2

In parallel with growing epidemiologic recognition, neurologists and trainees have found more avenues for clinical involvement abroad. Numerous models exist, from brief visiting professorships, global brigades and mobile clinics to long-standing inter-institutional collaborations. Here, we briefly reflect on our experiences with several models and future directions.

Many opportunities are available at individual medical schools for students to spend a week or more abroad, shadowing in hospitals or freestanding clinics, or setting up makeshift clinics to provide acute, primary care to all comers. As a starry-eyed trainee, these rotations can be inspiring, yet raise concerns. In one author’s experiences (JF), during 10- to 14-day-long trips to Central America and Jamaica, such makeshift clinics were erected and provided care to hundreds of patients who might otherwise be untreated. In addition to such ubiquitous primary care concerns of headache and low back pain, countless individuals with intestinal parasites, malaria and other tropical diseases were treated. Such trips inevitably raise the question of sustainability, and whether we are instantiating a culture of “duffle bag medicine” that does more harm than good.3 For example, a day laborer and father of six in his early 40s presented to our Jamaican clinic with early-onset Parkinson’s disease. As a student, one’s initial thrill at recognizing clinical signs and making a diagnosis is quickly overshadowed by the knowledge that the one-month supply of carbidopa-levodopa available may only offer the patient 30 days of false hope.

Some of these shortcomings can be overcome with careful pre-trip collaboration with local practitioners. Arrangements can be made in advance for patient referrals, and the visiting clinicians can arrive with a working knowledge of local treatment patterns and availability. Short trips and pop-up clinics often spark a more deep-seeded commitment to global health that will shape participants’ careers. Furthermore, relationships formed between visiting trainees and local providers can be nurtured into fruitful partnerships in the future.

To that end, longer-term collaborative relationships have been formed, yielding additional opportunities for trainees. A key component to ensuring sustainability in these relationships is to work closely with local providers and carefully elicit their input about the needs at their institutions. These partnerships can be focused on building collaborative research projects as well as fostering a didactic exchange and improving medical education.

One example of such a formal collaboration is the Botswana-UPenn Partnership. Established as a means of building clinical and research capacity in Botswana in response to the HIV epidemic, this decade-long connection has fostered the growth of primary care residency programs in Botswana, countless research studies, and the Global Health Equities Residency Track at the University of Pennsylvania’s various residency programs.

While medical students and residents can apply to spend a single rotation in Botswana, the track provides U.S. trainees with in-depth training on the geo-socio-political context of the nation in which they will practice. Two four- to six-week-long rotations are spent on the medical wards in Botswana, providing clinical care and engaging in a scholarly pursuit. Working with partnership-affiliated attending physicians and local practitioners, trainees are incorporated into ward teams or able to provide specialty consultation services. Extended and repeated stays provide invaluable insight into the epidemiology of disease, team practices, as well as the challenges of providing the best possible care with the available diagnostic and therapeutic modalities. Neurologic  in-patients tend to be plentiful, comprising about 30 percent of all medical admissions, with stroke, epilepsy, meningitis, Guillain-Barre, myelopathies and CNS complications of HIV/AIDS, among the most common chief complaints.

While rotating at a partner site, there are numerous opportunities to contribute to the medical education, clinical care and research efforts in collaboration with local providers. Such collaborations have infinite future directions. Investing in the education of trainees and students at the site is a first and crucial step to improve the care of neurological patients in a sustainable fashion. At partner sites with no local neurologist, one way to support local providers is to create a targeted curriculum, based on the most commonly seen, treatable conditions and available resources. Also, participating in teaching initiatives at the local medical school and inspiring young trainees in these areas to pursue a career in neurology can potentially improve neurological care within the country.

Research initiatives may improve diagnostic and therapeutic options in countries with limited resources. Also, scholarly pursuits can be fostered through organized mentorship as well as joint authorship of case reports and research studies. New advances in technologies also lead to a wealth of opportunities for continuous interaction and collaborative efforts between sites. The Partners Neurology Residency Program has initiated a recurring series of teleconferences with their partner sites in Uganda and Mexico, during which residents and faculty at both sites discuss interesting cases, provide neurological consultation or share didactic conferences. Another advantage of telemedicine is the potential to share neuroimaging studies, EEG data files and pathology images. While difficulties with the Internet connection in developing countries remain a major challenge for videoconferencing and the transfer of larger files, continuous communications via email and emerging technology can foster a frequent exchange between sites and perpetuate sustainable connections.

Numerous other models exist for global neurology collaborations, including Medical Education Partnership Initiatives (MEPI), NIH/Fogarty program, established visiting professor programs, AAN’s Global Health Section, and WFN’s International Working Group of Young Neurologists and Trainees. Furthermore, opportunities for participation increase as students and residents advance in their training.

The most critical step in any collaboration, however, is to ensure mutual understanding and benefit, with an eye toward building capacity for neurologic care in developing nations. Barriers to such programs include funding, limited or no pre-trip training for clinicians causing misunderstandings once in country, and poor resource sharing.

In addition to international partnerships, we recognize the tremendous potential for collaborations among globally minded neurology departments and trainees in the developed world to facilitate these exchanges, share resources and foster funding opportunities. We are currently laying the groundwork for a Neurology Global Health Consortium by uniting interested and experienced neurologists from across the U.S. By gathering the collective wisdom of individuals with experience in clinical practice, education and research abroad, we hope to learn from each other and serve as a resource for other interested trainees.

To learn more about the proposed consortium, contact Wahlster at swahlster@ partners.org. To learn more about additional opportunities, contact Fleisher at jori.fleisher@uphs.upenn.edu.