Citation, summary, extract and comment from me below.
CITATION: Lancet Global Health, Volume 14, Issue 6103933 June 2026 Open access
Time to confront the global health crisis hidden in plain sight: why traumatic brain injury belongs on the global health agenda
Global Coalition for TBI as a Notifiable Chronic Condition*
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(26)00063-X/fulltext?dgcid=raven_jbs_etoc_email
SUMMARY
Traumatic brain injury (TBI) is a growing global public health crisis that affects people in all regions of the world and across all age groups, with varied aetiology. Importantly, most of the TBI global disease burden affects those located in low-income and middle-income countries, where access to timely, safe, and quality care is more challenging. Improving care for TBI requires the synergistic efforts of multiple professional groups by coordinating prevention strategies, pre-hospital systems, emergency and acute care treatment, and support for chronic disease consequences. In 2022, WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders focused new attention on neurological conditions, offering an opportunity for TBI advocates to use this framework to improve the care of TBI for all. In this Viewpoint, we highlight how strengthening TBI care requires addressing all phases of the care continuum, from coordinating surveillance efforts to develop targeted prevention strategies, to upscaling pre-hospital referral pathways and acute care infrastructure. Furthermore, the large chronic burden of TBI needs to be recognised globally, where rehabilitation and long-term support need to be expanded and adequately resourced.
EXTRACT
In many LMICs, pre-hospital systems (eg, emergency medical services and first responder and ambulance services with or without trained paramedics or medical personnel; pre-hospital systems organise care that is provided to patients before they arrive at a hospital) are underdeveloped or absent, with delayed transport, limited early resuscitation, and fragmented trauma networks. In better-resourced settings, acute care pathways can be poorly coordinated, hindering the ability to minimise secondary brain injury and smooth transitions into community care. Strengthening acute TBI care, including pre-hospital care, aligns with broader investments in trauma systems, universal health coverage, and emergency preparedness, yielding benefits that extend beyond TBI.
COMMENT (NPW): Given that pre-hospital systems are underdeveloped or absent in LMICs, it is all the more important that first responders act correctly to minimise risk of death and long-term disability. WHO published a manual in 2004 on this subject:
'This manual is intended for mid-level rehabilitation workers and primary health care personnel as an educational and instructional tool to use for their work with persons who have sustained traumatic brain injury, their families and members of their communities. The manual contains common medical, physical, cognitive and behavioral consequences of brain injury, and basic information for helping caregivers and community members, including teachers and potential employers.'
https://www.who.int/publications/i/item/rehabilitation-for-persons-with-...
A recent paper (2024) notes: 'Low- and middle-income countries (LMICs) bear over 90% of trauma-related fatalities, with patients experiencing more than twice the odds of dying from severe TBI compared to high-income countries (HICs) due to inadequate surgical care, treatment delays, and differing management practices. Existing TBI management guidelines are primarily designed for HICs, assuming advanced medical infrastructure and resources not available in LMICs, leading to suboptimal outcomes when implemented in these settings. There is an urgent need for resource-stratified guidelines tailored to the constraints of LMICs to improve patient outcomes. This paper discusses the current TBI burden in LMICs, emphasizes the importance of developing such guidelines, and explores efforts made
toward achieving this goal.' https://share.google/1JKXBbdiGfa3XdRgK
What is your experience with traumatic brain injury? Can you recommend any publications or videos that can help meet information needs?
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org