Brain health is the state of brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains, allowing a person to realize their full potential over the life course, irrespective of the presence or absence of disorders.
Different determinants related to physical health, healthy environments, safety and security, life-long learning and social connection as well as access to quality services influence the way our brains develop, adapt and respond to stress and adversity. These give way to strategies for promotion and prevention across the life course. Optimizing brain health by addressing these determinants not only improves mental and physical health but also creates positive social and economic impacts that contribute to greater well-being and help advance society.
However, conditions affecting the brain and nervous system in general emerge throughout the life course and are characterized by disruptions in brain growth, damage to brain structure and/or impaired brain functioning. These include for example congenital and neurodevelopmental conditions as well as neurological disorders across the life. Health and social care for these conditions require multisectoral and interdisciplinary collaborations with a holistic person-centred approach focused on promotion, prevention, treatment, care and rehabilitation and the active engagement of persons with lived experience, their families and carers.
The global burden of neurological and neurodevelopmental conditions is high, with approximately 70% of the burden in low- and middle-income countries. Neurological conditions are the leading cause of disability adjusted life years (DALYs) and account for about 9 million deaths per year.
The largest contributors of neurological DALYs in 2016 were stroke (42.2%), migraine (16.3%), dementia (10.4%), meningitis (7.9%) and epilepsy (5%). Parkinson disease, propelled by an increasingly ageing population, is the fastest growing neurological disorder. Premature birth, neonatal encephalopathy and neuroinfections contribute substantially to high disease burden in South-East Asia and Africa. In 2016, developmental disabilities accounted for 13.3% of the 29.3 million years lived with disability for all health conditions among children younger than 5 years.
Despite the large burden, only 28% of low-income countries have a dedicated policy for neurological diseases in comparison with 64% of high-income countries. Available resources for these conditions are insufficient in most countries, with unacceptably high treatment gaps for many neurological and neurodevelopmental conditions. For example, in low- and middle-income countries, there are only three adult neurologists per 10 million people while high-income countries have approximately 160 times more. Resources for the assessment and care of children with neurological and neurodevelopmental conditions are even more scarce.
In May 2022, WHO Member States adopted the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031. This action plan aims to improve care, recovery, well-being and participation of people living with neurological disorders across the life-course, while reducing associated mortality, morbidity and disability associated with neurological conditions.
In the context of Universal Health Coverage and the UN Sustainable Development Goals and in line with WHO’s existing mandates for conditions affecting the brain such as autism spectrum disorder, epilepsy and dementia, WHO’s brain health work is focused on promoting optimal brain development, cognitive health and well-being across the life course. The main activities involve:
- strengthening policies, service delivery, health information systems, technology (including but not limited to artificial intelligence, e-health and big data), research and innovation, especially in low- and middle-income countries;
- providing technical assistance on how to formulate an integrated approach to brain health conditions focused on promotion, prevention, treatment, care and rehabilitation, focusing on low- and middle-income countries; and
- fostering increased investment and inter-agency collaboration globally as well as the involvement of different specialties and sectors.