Candidate Statement for Elected WFN Trustee: Morris Freedman, MD, FRCPC

I have had the honor to serve as a WFN Trustee since 2015. I now have the privilege of also serving as the newly appointed Chair of the Membership Committee.

Morris Freedman, MD, FRCPC

Morris Freedman, MD, FRCPC

I have served as the Canadian delegate to the WFN, a member of the WFN Education Committee, and Co-Chair of the eLearning Task Force of the Education Committee, alongside Prof. Riadh Gouider from Tunisia. I have also served as president of the Canadian Neurological Society, Canadian Congress of Neurological Sciences, and Federation of National Specialty Societies of Canada. My clinical and research foci are on dementia.

I am honored that the Canadian Neurological Society has nominated me for re-election as a WFN Trustee. I am also proud that Canada has initiated a WFN Department Visit program for young neurologists from Central and South America through the efforts of Prof. Guy Rouleau, director of the Montreal Neurological Institute and Canadian Delegate to the WFN. I am also proud of the Canadian Open Neuroscience Platform, which has its base at the Montreal Neurological Institute, and which is well-positioned to serve as an integrator and facilitator of education worldwide.

Achievements

I have taken an active international leadership role in education. Since 2005, I have focused on eLearning using videoconferencing as an electronic medium to bring together health care professionals from across the globe within a virtual classroom. This has been done within the context of international videoconference rounds in behavioral neurology. The goal is to develop greater international communication and links in behavioral neurology, and to transfer knowledge at the basic science and clinical levels internationally through joint educational programs. The audiences are multidisciplinary and include neurologists, psychiatrists, geriatricians, family physicians, nurses, social workers, occupational therapists, and psychologists, as well as trainees in these disciplines. I was awarded the prestigious Colin Wolf Award from the Faculty of Medicine, University of Toronto, for this initiative.

An important development that was modeled on the international behavioral neurology videoconference rounds was the formation of international neurology resident rounds in 2008, i.e., the Neurology International Residents Videoconference and Exchange (NIRVE) that promotes international collaboration among neurology trainees. Participating sites have included Brazil, Canada, Chile, Ethiopia, France, Jordan, Nigeria, and Russia. In addition to the rounds, NIRVE has led to resident exchange visits.

I have collaborated with Prof. Riadh Gouider to create a special series of international videoconference rounds in Behavioral Neurology involving Africa and Canada, and which has been supported by a WFN grant.

Goals

My major goal as WFN trustee is highly focused on education through eLearning and is directly related to the mission of the WFN to foster quality neurology and brain health worldwide by promoting “global neurological education and training with the emphasis placed firmly on under-resourced parts of the world.” I will continue working hard to achieve this goal through innovative eLearning programs involving our network of international sites for videoconference rounds that target neurologists, allied health care professionals, and trainees in neurology and related disciplines. The ongoing programming series will involve both developing and developed countries with a view to transferring knowledge from one to the other in both directions with all participants as equal partners.

A new goal is to significantly expand this eLearning network and broaden the focus from our highly successful behavioral neurology series to include a broad spectrum of disciplines within neurology.

I recognize the financial challenges facing under-resourced parts of the world and the barriers that this poses for successful knowledge transfer through eLearning. However, in keeping with the mission of the WFN to promote global neurological education and training, I will apply all the resources at my disposal to help fulfill this mission with full emphasis on under-resourced regions.

In addition to my goal related to eLearning, I hope to have a major impact on increasing membership in the WFN through my new position as chair of the Membership Committee. Furthermore, I will serve the WFN in any other way that I can.

I have a vision, a clear sense of direction, and the focus to facilitate knowledge transfer for enhancing brain health across the world, especially where it is needed the most. This will require extensive collaboration and coordination involving many people with diverse needs, and across many countries. Those who know me say that I am an excellent team player and organizer, qualities that are essential for success in promoting education and training in neurology worldwide. •

Receiving “the Call” From the Nobel Committee

A conversation with Stanley Prusiner

By Douglas J. Lanska, MD, MS, MSPH, FAAN

In an oral history interview for the American Academy of Neurology, conducted April 27, 2017, at the Boston Convention Center, I spoke with Nobel laureate Stanley B. Prusiner, the only living neurologist who has won a Nobel Prize (Lanska and Klaffke, 2017, Lanska, 2017). Prusiner was the sole recipient of the Nobel Prize in Physiology or Medicine in 1997 “for his discovery of Prions — a new biological principle of infection.”

Here is an excerpt from that interview concerning the call at 5:05 a.m. EDT on Oct. 6, 1997, from the Nobel Committee, notifying Prusiner that he had won the Nobel Prize in Physiology or Medicine (Prusiner, 2014, p. 218). The call was from cell geneticist Nils Ringertz (1932-2002), professor and chair of the Department of Cell and Molecular Biology at the Karolinska Institute in Sweden, who was then-secretary of the Nobel Committee for Physiology or Medicine, as well as a member of the Nobel Foundation’s Board of Directors.

Lanska: When you got the call that you had won the Nobel Prize, [what was] your reaction to that call?

Prusiner: First of all, my ex-wife [Sandy Turk Prusiner], who was my wife at that time, she got the call. She was in San Francisco, and I was in Bethesda at an FDA meeting. She got the call, then she told them where I [was]. Then, the guy woke me up. I knew him. I had met him. [He was] named Nils Ringertz.

He said, “Do you remember me?” I said, “Yes! We had dinner together six months earlier.” He said, “Well, we’ve decided that we’re going to give you the entire prize.” That was really a surprise to me. I thought surely they were going to have some other people. And, you know … I was shocked, because I knew people were nominating me for three or four years before that.

It was really nice, but it wasn’t as though I was jumping up and down. It was just really nice that this had happened. I thought this is great.

People would ask me all the time, “How does it feel?” I would say, “You know, I recommend this.” It’s a nice thing to have happen to you.

Lanska: “Yeah, everybody, I recommend it!” [laughter]

Prusiner: I sat there, and I was sort of stunned. I was really stunned about the whole thing, about getting the prize alone.

Then I turned on CNN, and there was nothing about this Nobel Prize or any Nobel Prize at that moment. The time goes on and on, and I’m not finding anything, and I think this is a hoax, because I knew this had happened. It’s not the first time some reporter called up and convinced somebody that they had been given the Nobel Prize. But this was not a joke. This was real. But I said, “I screwed up,” because I should have said to Nils Ringertz, “I don’t want to recite to you where I met you. I want you to recite to me where you met me, so I know it’s you.’” I didn’t do that. I said, “Well, alright.”

Then, 7 a.m. comes, and there’s nothing more on the TV. I turn on the radio. That I found a radio was amazing. The radio was on, and then there it’s all laid out, and I said [expressing relief], “Oh, OK.”

Skepticism Abounds

Prusiner’s skeptical reaction that the call might be a hoax was certainly not unique among Nobel laureates. Many, if not most, Nobel laureates are initially skeptical. For example, Romanian-born German physicist Stefan W. Hell (Chemistry 2014) said, “The first moment I thought it was perhaps a hoax” (Hell, 2014). Similarly, British-American economist Sir Angus S. Deacon (Economics 2015) recalled:

“And then they were very keen to make sure that I did not think it was a prank. I don’t know whether this is common. I’ve never had a prank phone call telling me that. And, of course, as soon as they said that, I thought, ‘Oh, my god, maybe it is a prank.’” (Dubner, 2015)

Several recipients have suspected that their students had orchestrated a prank. Australian physicist Brian P. Schmidt (Physics 2011) recalled, “I’m thinking, ‘Jeez, my graduate students are getting pretty good with the accent this year.” (Taylor, 2011) Likewise, American physicist Richard P. Feynman (Physics 1965) ruefully recounted:

“I thought it was some student calling as a prank. I wasn’t too polite. But after the third call I was convinced. I hope the guys who called will accept my apologies.” (Hendrickson et al, 1965)

Many look for some means of verification, even during the call itself. For example, Scottish economist James A. Mirrlees (Economics 1996) remembered, “I politely suggested that I’d need some proof.” (Griehsel, 2004a)

American biologist and parasitologist William C. Campbell (Physiology or Medicine 2015) replied skeptically, “You must be kidding.” He later recounted, “The first thing I did after that was to ask for a way to verify that this could be genuine, because it just seemed impossible.” (Cohen 2015)

In 2015, the Wall Street Journal reporter Ben Cohen outlined a common reaction among newly informed Nobel laureates who were only convinced of the call’s veracity upon speaking to members of the awards committees with whom they were already familiar:

[M]any Nobel laureates start their celebrations in the same way. They assume it’s a prank call. The organizations that oversee the awards, including the Royal Swedish Academy of Sciences, are actually used to dealing with disbelief. They even have unofficial protocols for assuring the newly named laureates that they are not, in fact, at the center of an elaborate hoax. First, a calming Swedish voice says hello. But an accent would be easy to fake. Then he says that you have won the Nobel Prize. But that could be a lie too. Then he might insist it isn’t a prank. But, of course, he would say that. For some winners, only when he passes the phone to members of the committee whom they know personally does the achievement finally sink in. (Cohen, 2015)

The scenario outlined by Cohen has indeed been described by several Nobel laureates. For example, it wasn’t until the caller passed the phone to members of the Chemistry Committee that American physiologist Brian K. Kobilka (Chemistry 2012) believed the call was not a prank: “Then I really knew it was real; you know, I don’t think any of my friends, first of all, would be able to put together such an elaborate hoax.” (Kobilka, 2012) Likewise, American astrophysicist and cosmologist George F. Smoot (Physics 2006) recounted:

“So they called, and at first, I thought I’d better be careful, this could be a hoax or something like that. But the guy sounded really serious and the next guy had a Swedish accent, so you know … I think I’d better take him really seriously. And so finally somebody I knew got on the phone, so I thought this was either a really elaborate hoax or this is the real thing, and I was kind of believing it, but I thought I better get on the web and check.” (Smoot, 2015)

Most, like Prusiner and Smoot, seek verification in the media or on the internet. For example, American geneticist and chronobiologist Jeffrey C. Hall (Physiology or Medicine 2017) replied, “Is this a prank?” “I didn’t really believe it,” he later said. The caller responded, “No, it’s not a prank,’’ but Hall wasn’t convinced until the Nobel Prize Assembly posted the official announcement later that morning (Koch and Hall, 2017; McCrea, 2017; Ritter and Heintz, 2017). Similarly, American economist William F. Sharpe (Economics 1990) recalled:

“…and then, of course, your second thought is it’s a hoax, one of your friends or colleagues. After we’d finished the chat, we turned on CNN and within about 5 minutes the first announcement came across, and it had many inaccuracies… but nonetheless there was enough there that we were pretty sure that it was real.” (Griehsel, 2004b)

British novelist Kazuo Ishiguro (Literature 2017) said:

“I thought it was a hoax in this time of fake news and everything. I didn’t believe it for a long time. Then, my publisher phoned, and finally when the BBC phoned, I thought it might be true.” (Ishiguro, 2017)

Swedish jurist Beatrice Fihn, the director of the International Campaign to Abolish Nuclear Weapons (ICAN) (Peace 2017) similarly said:

“I was worried that it was a prank. You just get so nervous that maybe it’s not real. So, it wasn’t really until the actual broadcast, when [the announcer] spoke and said the name ICAN, that we really understood that it was real.” (Fihn, 2017)

In some cases, the first call the scientist received was from a reporter, but typically their reactions were similar to those engendered by the calls from Stockholm. In response to a call from a reporter at CBS New York, Swiss-American geneticist Edmund H. Fischer (Physiology or Medicine 1992) said, “I don’t believe you. What are you saying?” (Chu, Fischer, et al, 2016)

Similarly, a reporter called and asked American physicist Steven Chu (Physics 1997), “How does it feel to win a Nobel Prize?” Chu responded suspiciously, “Is this real?” The caller said, “Oh yes, it’s actually on the Web.” Chu countered disapprovingly, “You believe everything you hear on the Web?” (Chu, Fischer, et al, 2016)

While Prusiner believed that prank calls have occurred falsely notifying scientists that they have won a Nobel Prize, I found no clear evidence of this. The idea has certainly been discussed by scientists, though, as noted by Wall Street Journal reporter Ben Cohen:

Whether or not a prankster has ever pulled off a successful Nobel Prize caper is uncertain. But there are at least some laureates who think the con could work. Dr. [Venkatraman] Ramakrishnan [Chemistry 2009], for one, said the idea has popped up in conversations with friends who love practical jokes. There are some scientists, he said, who almost actively campaign for the honor. That only makes them easier targets.

“We often thought it would be great fun to have some Swedish postdoc call them up and say you’ve won the Nobel Prize,” he said. “But we’d never do it.” (Cohen, 2015) •

Douglas J. Lanska, MD, MS, MSPH, FAAN, is associate chief of staff for education at the VA Medical Center in Tomah, Wisconsin and professor of neurology at the University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin; professor of psychiatry at the Medical College of Wisconsin in Milwaukee, Wisconsin; and chair of the History and Archives Committee of the American Academy of Neurology.

References
Chu S, Fischer E, et al. When Stockholm called. iBiologie, September 28, 2016. https://www.youtube.com/watch?v=Giq-CJ8cxuo [Accessed 12-24-17]

Cohen B. Is your refrigerator running? No, really, you won a Nobel prize: Persuading laureates they’re winners can be a tough call; ‘It’s not a prank.’ Wall Street Journal, October 7, 2015. https://www.wsj.com/articles/is-your-refrigerator-running-no-really-you-won-a-nobel-prize-1444266470 [Accessed 12-15-17]

Dubner SJ. How to win a Nobel prize: a new Freakonomics radio episode. October 15, 2015. http://freakonomics.com/podcast/how-to-win-a-nobel-prize-a-new-freakonomics-radio-episode/ [Accessed 12-15-17]

Fihn B. Ican director: I thought Nobel peace prize win was a prank. Guardian News, October 6,2017. https://www.youtube.com/watch?time_continue=16&v=csmqDwChaSE [Accessed 12-26-17]

Griehsel M. Interview transcript. Transcript from an interview with Professor James A. Mirrlees at the 1st Meeting of Laureates in Economic Sciences in Lindau, Germany, September 1-4, 2004. Nobelprize.org, 2004a. https://www.nobelprize.org/nobel_prizes/economic-sciences/laureates/1996/mirrlees-interview-transcript.html [Accessed 12-24-17]

Griehsel M. Interview transcript. Transcript from an interview with Professor William Sharpe at the 1st Meeting of Laureates in Economic Sciences in Lindau, Germany, September 1-4, 2004. Nobelprize.org, 2004b. https://www.nobelprize.org/nobel_prizes/economic-sciences/laureates/1990/sharpe-interview-transcript.html [Accessed 12-24-17]

[Hell S]. Chemistry laureate thought Nobel call was a ‘hoax.’ Agence France-Presse, October 8, 2014. https://www.ndtv.com/world-news/chemistry-laureate-thought-nobel-call-was-a-hoax-676620 [Accessed 12-15-17]

Hendrickson T, Galley S, Lamb F. Richard P. Feynman: Nobel prizewinner. Engineering and Science 1965;29(2):10-13.

Ishiguro K. Nobel winner Ishiguro’s reaction: ‘It was a hoax’: The newest winner of the Nobel Prize for Literature, Kazuo Ishiguro, tells media that he didn’t know he’d won until journalists started looking for him. The Washington Post, October 5, 2017. https://www.washingtonpost.com/video/world/nobel-winner-ishiguros-reaction-it-was-a-hoax/2017/10/05/15dd1fc2-a9f7-11e7-9a98-07140d2eed02_video.html?utm_term=.928ea03f189a [Accessed 12-15-17]

Kobilka B. 2012 Chemistry winner let Nobel call go to voice mail. Morning Edition, Wisconsin Public Radio, October 9, 2015. https://www.npr.org/2015/10/09/447098680/2012-chemistry-winner-let-nobel-call-go-to-voicemail [Accessed 12-15-17]

Koch M, Hall J. A Nobel pursuit may not run like clockwork. Cell 2017;171:1246-1251.

Lanska DJ, Klaffke L. Stanley Prusiner, MD, FAAN. American Academy of Neurology Oral History Archive Private Interview. 69th Annual meeting of the American Academy of Neurology, Boston, Massachusetts; April 27, 2017.

Lanska DJ. Stanley Prusiner, MD, FAAN. American Academy of Neurology Oral History Archive Public Interview. 69th Annual meeting of the American Academy of Neurology, Boston, Massachusetts; April 27, 2017.

McCrea N. Once ridiculed researcher and retired Cambridge resident wins Nobel Prize. Piscataquis Observer, October 4, 2017.

https://observer-me.com/2017/10/04/once-ridiculed-researcher-and-retired-cambridge-resident-wins-nobel-prize/ [Accessed 12-15-17]

Prusiner SB. Stockholm. In: Madness and Memory: The Discovery of Prions—A New Biological Principle of Disease. Yale University Press, 2014:213-231.

Ritter M, Heintz J. Biological clock discoveries by 3 Americans earn Nobel prize.

Associated Press, October 2, 2017. https://www.apnews.com/23246a2d670b460481305d4f9702b900 [Accessed 12-15-17]

Smoot G. US scientists react to news of Nobel Prize win. Associated Press, July 23, 2015. https://www.youtube.com/watch?v=dSZmGfYAd9Y [Accessed 12-25-17]

Taylor R. Australian Nobel winner thought prize call was a prank. Reuters, October 4, 2011. https://in.reuters.com/article/idINIndia-59711220111005 [Accessed 12-15-17]

From the Editors

BY STEVEN L. LEWIS, MD, EDITOR,
AND WALTER STRUHAL, MD, CO-EDITOR

Welcome to the June issue of World Neurology. The issue begins with Prof. William Carroll’s President’s Column, where he updates us on several of the many current and upcoming activities of the WFN, which are only possible through the many valuable and multifaceted contributions of our many constituents. This issue also includes the exciting news that Vladimir Hachinski, a previous WFN president, has received the 2018 Killam Prize, the highest honor for research from the Canada Council of the Arts.

Steven L. Lewis, MD

Walter Struhal, MD

Prof. Wolfgang Grisold reports on the Austrian World Summit, which took place in May. The summit was dedicated to the environment and was organized by the Schwarzenegger Institute and the Austrian government. In this issue’s history article, Douglas Lanska provides the second part of his interview with Nobel Laureate Stanley Prusiner describing when he received the call from the Nobel Committee.

In education news, Prisca Bassole reports on the recent graduation of four trainees from the new neurophysiology fellowship in Dakar, one of the WFN-accredited teaching centers in Africa. In other education reports, three recent recipients of WFN’s Junior Traveling Fellowships provide their accounts of their travel to conferences to report on their research and to learn of cutting- edge developments in neurology.

Finally, this issue includes the statements from the candidates for the positions up for election at the upcoming Council of Delegates meeting in Berlin. For the WFN Trustee Elections, the candidates are (in alphabetical order) Morris Freeman, Alla Guekht, Jean-Marc Leger, and Daniel Truong, and for WFN Secretary General Election, the candidate is Wolfgang Grisold.

We hope you enjoy the contributions in this issue, and we continue to encourage future contributions from neurologists about neurology from around the world. We also remind all readers of the upcoming Day of the Brain on July 22, with the theme of Clean Air for Brain Health¸ and look forward to participation from neurologists and neurology societies from around the globe.•

A Man of Art and Science

Vladimir Hachinski, famed stroke and dementia researcher, wins 2018 Killam Prize

By Crystal Mackay

Dr. Vladimir Hachinski believes medicine and art are unequivocally linked.

Schulich School of Medicine & Dentistry professor Vladimir Hachinski, past president of the World Federation of Neurology and a world-renowned stroke expert, has been named a 2018 Killam Prize winner for Health Sciences. Hachinski is only the sixth Western University researcher to be given this honor. Photo credit Frank Neufeld // Western News

“The science of medicine lies in the technology, the knowledge, the algorithms. But the art of medicine begins where the technology ends – and that’s where good doctors excel,” said the world-renowned expert in the relationship between stroke and dementia, who also happens to be a composer and poet.

Today, the coalescence of his passion for art and health care have come together. Hachinski has been named a recipient of the Killam Prize, the highest honor for research from the Canada Council of the Arts. He is the sixth Western University researcher to be given this honor, which recognizes the career achievements of eminent Canadian scholars and scientists actively engaged in research, whether in industry, government agencies, or universities.

Five prizes of $100,000 are awarded each year, one prize in each of the fields of humanities, social sciences, natural sciences, health sciences, and engineering.

“I am delighted by the honor. But I realize this is not just about me; it is about all the work we have done,” said Hachinski, a Distinguished University Professor and Professor of Neurology at the Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. “I am left with a tremendous feeling of gratitude – gratitude for the acknowledgement, but even more importantly, gratitude because it gives an opportunity to highlight what we are doing, and where we are trying to go, which is the most exciting thing.”

When he began his career, it was the commonly held belief in the medical profession that dementia was caused by hardening of the arteries which reduced blood flow to the brain. Early on, he discovered the majority of dementias were actually caused by multiple, small strokes. Hachinski coined the term “multiple-infarct dementia” in order to classify this condition.

“In that way, medicine is like poetry; I needed to boil it down to a simple term by using language to get to the essence of something.”

His love for both the arts and medicine began when he was a boy. His family fled the Soviet Union and emigrated to Venezuela when he was 7 years old. Hachinski would watch birds and animals out of his window. Inherently curious, he would sketch and draw them, wanting to understand how they moved and how their bodies worked.

In Venezuela, there was an expectation in high school that a student had to choose to study either arts and humanities or science – not both. Hachinski said it was a difficult and defining moment for him.

“I really was torn between medicine and history. How do you choose between two passions?”

The decision was a practical one.

“If I became a historian, I couldn’t really be an amateur doctor, whereas if I became a doctor, I could be an amateur historian,” said the man who even today often seeks guidance from poets.

Since earning his medical degree from the University of Toronto after his family emigrated to Canada, Hachinski has transformed the understanding, diagnosis, treatment, and prevention of the two greatest threats to the brain: stroke and dementia.

Early in his neurology residency, Hachinski became intrigued by the interaction of the brain, its blood supply, and the heart. He developed the Hachinski Ischaemic Scale, which is considered to be the most widely used clinical method to identify the difference between degenerative dementia (like Alzheimer’s disease) and multi-infarct dementia (cognitive impairment caused by multiple strokes).

Throughout his career, he has authored more than 800 well-cited research papers and has authored, coauthored, and edited 17 books. He founded, with John W. Norris, the world’s first successful acute stroke unit, and went on to establish the first stroke clinic in London, Ontario. That has led to stroke units being established around the world and has laid the groundwork for what is now considered the standard of care.

He received the Order of Ontario and Order of Canada. He was the president of the World Federation of Neurology from 2010 to 2013 and was inducted in the Canadian Medical Hall of Fame in 2018.

With all of those accomplishments, Hachinski said there have also been setbacks, and part of what has led to his successes has been the ability to persevere.

“If you are in research, you better be prepared for setbacks. I don’t think failing makes you a failure; failing to learn from them is a failure,” he said. “There is a continuous alternation between disappointment and triumph, and this is an important lesson.”

However, Hachinski believes his most important contribution to human health isn’t in what he has done in the past, it is in what’s coming next.

He and his team are keen on using experimental, clinical, and population health data together to implement strategies to prevent stoke and dementia together. In 2006, he and a group of colleagues helped establish World Stroke Day, which has contributed to increasing awareness of the prevention of risk factors for stroke.

They have already shown a new stroke initiative in the province of Ontario correlated with a 30 percent reduction in the incidence of stroke, and in turn, a 7 percent reduction in the incidence of dementia.

“This was the first time that we were able to show if you prevent one, you can prevent the other,” Hachinski said. “The end goal is to prevent, delay, or mitigate disease, and I think that we already have. Right now, we could prevent 90 percent of strokes if we did everything perfectly. And if we did everything perfectly for dementia, we could prevent 30 percent.”

He and his collaborators are working to persuade decision-makers to enact approaches that look for ways to prevent the two as part of the same strategy. He said it all comes back to looking at stroke and dementia, not in isolation but as part of the same.

“By doing this, we may able to change things for the better in a relatively short time,” he said.

With this announcement, Hachinski becomes Western’s sixth Killam Prize winner and the most recent winner since English professor David Bentley won in 2015. Other Western winners include Economics professor John Whalley (2012), Engineering professors Alan Davenport (1993) and Maurice Bergiougnou (1999) and Robarts Research Institute co-founder Henry Barnett (1988).

This story is reprinted with permission from Western News, a Western University publication.

The Value of Shared Commitment and Contribution

As we approach the halfway mark of the current calendar year and as many watched the World Cup, perhaps the greatest display of a world team game, it is worth reflecting on the value of teamwork. Teamwork is at the center of all organizations engaged in goal-oriented endeavors, sporting or otherwise. It is especially evident in those organizations that are successful and in those within the not-for-profit area.

William Carroll, MD
 

Teamwork is essential to energize existing activities and drive new ones: At its heart is the knowledge that all team members share the same commitment and all will make the best contribution they can. Teamwork has a role in the WFN, and I would like to review this fundamental, yet largely intangible, essence in relation to our organization this year.

A solid, stable organizational base and a sound financial state are important but the most critical is the sense of teamwork, of a shared commitment, of reliable interdependence and of equality of worth through the contribution of each member society to the advancement of the WFN.

Let me illustrate by touching on some contributions. I preface this by saying how heartening it is to see these contributions grow.

Regional Training Centers in Africa. These were initiated first in Africa, though the WFN has had a program to evaluate neurology departments and institutions for a much longer period when they were commenced by Ted Munsat in Central America. Now in Africa, we have four centers either actively training young neurologists for Africa or about to. But the pleasing aspect about contributions are those offered by the Association of British Neurologists , the Societe Francaise de Neurologie (SFN), the Società Italiana di Neurologia, and the large regional organizations of the European (EAN) and American (AAN) Academies of Neurology. All have made offers of substantial contributions to the funding of the institutions and trainees.

Furthermore, the WFN has been informed that the SFN is preparing an offer for the WFN to fund another center in francophone Africa, in Abidjan, Cote d’Ivoire. This would bring the total to five such centers which will all receive funding through the WFN from the contributions from the societies I have mentioned.

Regional Organizations. There are six regional organizations in the WFN, which roughly matches those of the WHO. They range from the highly organized and well-financed AAN and EAN through to the African Academy of Neurology (AFAN), the last to be established in 2015. Now through the efforts of Neurological Association of South Africa (NASA) led by Lawrence Tucker, AFAN has its own bank account in South Africa enabling it to operate financially. However, because of the difficulties facing the African region, funding by pharma to support a biennial regular meeting is nigh on impossible at present. Such a lack of an income stream could jeopardize the future of AFAN.

Through the thoughtful teamwork of WFN member societies and individuals, promising discussions continue that should enable AFAN to maintain its development for the good of African neurology. The meeting planned for 2019 in East London, South Africa, will be held in conjunction with NASA, and thereafter additional collaboration is being planned.

World Congress of Neurology. As we all know, the 2019 WCN will beheld in Dubai and hosted by the Emirates Neurology Society (EMINS). We also know how important the WCN is to the WFN. It forms a major component of the WFN income along with the royalties from our publication, the Journal of Neurological Sciences (JNSci) and the annual subscriptions or dues from member societies. Any competition to the WCN from regional meetings has the potential to threaten the profitability of the WFN and consequently its educational programs and activities.

So it was with much pleasure that the WFN received the news that the Pan Arab Union of Neurological Societies (PAUNS) and its affiliated regional organizations have moved or cancelled all meetings in the region with the potential to compete with the 2019 WCN. While such a sacrifice by a regional organization has occurred previously it is still most heartening to see it in operation once more. Again, this reveals the actions of a team at work.

Annual Subscriptions. I have already mentioned the importance of the WFN income above. In this same sense of shared commitment and contribution, I encourage all member societies to view their annual subscriptions (known as dues) as being part of the team. While the amounts vary according to the numerical size of the member society, the very act of contributing establishes a sense of equality which in turn builds the morale of an organization. Furthermore, without funds the WFN cannot function.

On the Move. Within the London Office, there is the same sense of teamwork. As the office settles into its new operating calendar and record system (Asana), it can now look more externally. The WFN is most appreciative of the efforts of Chiu Keung Man for his direction on this and to the other office staff in general for their cheerfulness in continuing to keep everything functioning while the transition occurs. One of the more tangible features of an organization is its visibility. Logos, trademarks, and livery are the modern-day equivalents of flags and colors. They evoke a sense of pride and familial cohesion and represent the combined efforts and contribution of the organization’s many parts.

The London office is carefully reviewing all of the WFN logos and symbols on all platforms and media with which the WFN is seen so that it is immediately apparent to all viewers that an item, an article, a meeting, or a post on social media is from the WFN. Getting this right is fundamental to our visibility in the competitive world in which we exist and in signaling to our team that we do care how we are represented.

Your contribution to the WFN at the individual, member society, regional organization or WFN committee is crucial. Without it and the sense of equality of contribution, we will struggle to succeed.

Global Matters. I have mentioned in passing in my first column this year and in my statement of candidature in World Neurology last year of the desire for the WFN to develop a comprehensive registry of the needs of all member societies. This will become the Needs Registry. It will require the cooperative involvement of each of the regional organizations and their member societies in its preparation. In turn, it will provide an active survey of what is required to improve the delivery of neurological care. This will be the converse or opposite of what the WFN/WHO Atlas contains, which is the listing of resources available in each country and was obtained from a non-uniform range of sources and as such is less meaningful. Furthermore, the EAN is re-evaluating its survey of national neurological resources, the AAN plans a disparity file on its resources within the U.S., and the WHO announced at the 71st World Health Assembly in Geneva in May that it recognizes the inequality of access to health care and is preparing a more detailed and accurate inventory.

Together, if they all come to fruition, we will have a better overview of the needs, the basis for models of remedial action, and a potentially powerful tool with which to advocate for change at governmental and global levels.

At a larger scale of cooperative action is the informal support for a Global Neurology Alliance. During June’s EAN in Lisbon, there was encouraging support for the amalgamation of the World Brain Alliance and the Global Neurology Network, recognition of more regular communications to all through the WFN, and a suggestion of a more sustained and professional promotion of brain and neurological health. Clearly much needs to be done here but the sentiment of the need for teamwork at this level appears to be in line with that expressed by all neurological organizations.

Important Upcoming Events

World Brain Day (WBD)

Mohammed Wasay and his World Brain Day (WBD) team have again prepared numerous activities for individual member societies to join with to celebrate the formation of the WFN on July 22. This year, the theme is Clean Air for Brain Health (and healthy brain development).

WFN Annual General Meeting

The WFN Annual General Meeting will be Oct. 9 in Berlin during ECTRIMS. Not only must the WFN satisfy the requirements of the U.K. Charity Commission and ratify its financial position, there are also important elections.

Wolfgang Grisold’s four-year term as secretary general ends on Dec. 31. By being nominated by the Mexican, Moldavian, Moroccan, Romanian, and Italian societies, he offers himself for a further term.

The three-year term of Morris Freedman, elected trustee, is at an end, and he has offered himself again as a candidate. Three other candidates have been approved by the Nominating Committee and its outgoing chair, Marianne de Visser. All of the candidate statements are in this edition and can also be found on the WFN website. •

Bill Carroll
President, World Federation of Neurology

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