Neurological Care in Developing Countries

Founder of non-profit NGO Global NeuroCare®, Neurologist James C. Johnston, MD, JD has dedicated significant time and resources to improving neurological care in some of the least developed regions in the world.

Dr. James C. Johnston focuses the NGO on sub-Saharan Africa (SSA), a region plagued by the ‘triple burden’ of ongoing communicable diseases, rapidly increasing non-communicable disorders such as cancer, stroke and heart disease, and escalating problems directly attributable to globalization including increased accidents, climate related health issues, and most notably, the current SARS-CoV-2 pandemic (also known as COVID-19 or the Wuhan virus).

The most significant factor beyond the current pandemic adding to the overall disease burden in SSA is the increasing incidence of non-communicable disorders. Ethiopian neurologist Dr. Mehila Zebenigus and Dr. James C. Johnston discussed these non-communicable disorders at the United Nations High Level Political Forum and last World Association for Medical Law conference, focusing on the neurological diseases which afflict tens of millions of people, typically the young, causing cognitive impairment and physical disability, leading to loss of employment, marginalization, increased vulnerability and exclusion, contributing to a profound impact on the economy. The Global Burden of Disease Study underscored the fact that these neurological disorders are the main cause of disability worldwide. (Global, regional and national burden of neurological disorders during 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurology 2017.).

There must be improved access to neurological care in SSA in order to manage the increasing incidence of these diseases, which mandates addressing extraordinarily complex challenges such as a severe shortage of healthcare workers, poor infrastructure, limited transportation, and a dearth of supplies, equipment and medications, all compounded by abject poverty with food and water insecurity.

Global NeuroCare® focuses on improving healthcare access by establishing collaborative partnerships to increase the number of neurologists in SSA, and has worked with the Addis Ababa University Department of Neurology for the past fifteen years. This autonomous training program has been extraordinarily successful, having graduated over fifty board certified neurologists since inception in 2006. These neurologists not only see tens of thousands of patients but more importantly they train the general physicians to manage some of the common neurological conditions such as stroke, epilepsy and neuropathy. This teaching is an essential means of improving care in SSA, where it is unlikely there will ever be enough neurologists to meet the burden of disease.

Drs. Zebenigus and Johnston will attend the upcoming UN Forum to discuss the importance of maintaining collaborative partnerships, and caution against withdrawing, limiting or redirecting resources from ongoing programs to address the pandemic, as this would lead to increased morbidity and mortality from neurological diseases.

Advancing Neurology in Africa

A neurologist and attorney, James C. Johnston, MD, JD, is the founder of Global NeuroCare, a nongovernment organization (NGO). Global NeuroCare was established by Dr. James C. Johnston to improve neurological services in developing regions. Dr. Johnston and one of his Ethiopian colleagues Dr. Mehila Zebenigus, serve as Directors of this organization.

Holding Special Consultative Status with the United Nations ECOSOC, the highest status granted to an NGO by the UN, Global NeuroCare has engaged in a long-term collaborative partnership with Addis Abada University Department of Neurology to advance the training of physicians in Ethiopia. The Neurology Residency Training Program has been an outstanding success, substantially increasing the number of practicing neurologists in the country, leading to the treatment of more patients. These neurologists are also teaching a new generation of doctors to manage common neurological problems which represents the most effective was to improve healthcare in regions with a severe shortage of doctors and other healthcare providers.

On behalf of Global NeuroCare, Dr. Johnston and one of his Ethiopian colleagues Dr. Mehila Zebenigus have discussed the medical, ethical and legal aspects of advancing healthcare in developing regions at several meetings over the recent years including the United Nations High Level Political Forums, World Congresses for Medical Law and American Academy of Neurology conferences. They have highlighted the serious concerns of short term medical missions which fail to provide any substantive benefit to the host nation, and may cause significant harm to the local population. An additional concern is that developing nations have inherently vulnerable populations that may be intentionally or unintentionally exploited by these types of brief self-serving medical missions.

Drs. Zebenigus and Johnston presented the Ethiopian model to demonstrate that effective capacity development requires increasing the recruitment, training and retention of medical staff, which mandates stable long-term collaborative North-South partnerships focused on establishing local training programs, staffed by local physicians, to address the particular local community needs. They recently published a white paper for the UN on this topic, and will be present those recommendations at the 26th Congress Meeting of the World Association for Medical Law.

Global Neurocare Works with the UN to Combat Neurological Disorders

A prominent neurologist and medical law specialist, Dr. James C. Johnston has been in private practice for nearly 30 years. In addition to his work as a neurologist, James C. Johnston, MD, JD, also serves as a partner with Global Neurology Consultants, where he is mostly concerned with improving health care quality and access in developing regions. To further this vision, Dr. Johnston founded Global Neurocare, a nonprofit organization dedicated to advancing patient care and increasing medical training and research in developing countries such as Ethiopia.

Neurologists are scarce and resources limited in these developing regions, resulting in the needless deaths of those suffering from neurological disorders every day. Global Neurocare was granted Special Consultative Status with the United Nations in 2013, the highest status granted to a non-governmental organization. The Economic and Social Council (ECOSOC) Committee at the United Nations looks at numerous applications to find non-governmental organizations that coincide with the aims and purposes of other United Nations programs.

Members of organizations granted Special Consultative Status are able to serve as UN delegates at sessions in various locations around the world. Global Neurocare’s status with the UN allows it to raise public awareness, implement international trade agreements, and provide expert analysis on relevant issues, among other benefits. Neurological disorders are recognized by the World Health Organization as one of the greatest threats to public health, and organizations such as Global Neurocare are poised to help with the crisis.







Dr. James Christopher Johnston




Global Neurology Report: WHO List of Essential Diagnostic Tests







The full document may be accessed through the following link:

Click to access EDL_ExecutiveSummary_15may.pdf