Addressing global disparities in neurosurgical workforce and access to care

Abstract Neurosurgical care remains inaccessible to over two-thirds of the global population, with the greatest burden falling on low- and middle-income countries (LMICs). Neurological disorders contribute to nearly 9 million deaths annually, while an estimated 22.6 million new cases require neurosurgical attention each year. Workforce shortages, particularly in Africa and Southeast Asia, exacerbate this crisis, with many countries falling below the minimum target of 0.5 neurosurgeons per 100,000 population. Beyond workforce deficits, systemic barriers, including limited access to training, mentorship, funding, and equitable career advancement, compound disparities and hinder long-term retention. The Boston Declaration 2025 and the World Health Organization (WHO) Intersectoral Global Action Plan emphasize the integration of neurosurgical services into national surgical, obstetric, and anesthesia plans, alongside investment in mentorship, inclusivity, and institutional support. Telemedicine has shown promise in expanding access through remote consultations, teaching, and follow-up care, yet infrastructure and policy challenges persist. This correspondence focuses on addressing global inequities in neurosurgery, which requires multipronged strategies: workforce expansion, digital health adoption, systemic reforms, and embedding neurosurgical care into broader health frameworks. Sustainable progress will depend on consistent investment, evidence-driven policies, and global collaboration to ensure equitable access to neurosurgical care worldwide.