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Dr. Gail Rosseau delivering opening remarks at the Boston Declaration

From Pledges to Progress: Charting the Future of Global Neurosurgery

Guest Columns

Written by Noor Alesawy; Nicole A. Pérez, MD; Mohammad Ali Aziz-Sultan, MD; Kee B. Park, MD; and Gail L. Rosseau, MD. Edited and curated by Dr. Rosseau.

On April 24, 2025, the Boston Declaration convened over 500 representatives from more than 100 countries at the Edward M. Kennedy Institute in Boston, a full-scale replica of the United States Senate Chamber. The gathering brought together global stakeholders to assess the state of neurosurgical care worldwide and formalize 94 pledges representing specific, measurable, and actionable commitments toward advancing timely, safe, and affordable neurosurgical care globally. Keynote speakers included Ambassador Joseph P. Kennedy III and Dr. Alfredo Borrero, a neurosurgeon and former Vice President of Ecuador. The proceedings concluded with a digital signing of the Boston Declaration, symbolizing a collective resolve to address the persistent and substantial gaps in global access to neurosurgical care and education.

One year later, on April 15, 2026, the Boston Declaration Steering Committee convened its first annual follow-up meeting at the Hyatt Hotel in Dar es Salaam, Tanzania. This meeting followed a months-long organizational effort led by incoming Barrow neurosurgery resident Nicole A. Pérez, MD, who worked directly with pledging stakeholders for the year following the 2025 meeting to ensure ongoing pledge progress. The Dar es Salaam session began with opening remarks from Steering Committee members Gail Rosseau, MD, (Barrow adjunct professor of global neurosurgery), Kee Park, MD, (director of policy and advocacy for the Program for Global Surgery and Social Change at Harvard Medical School), and Noor Alesawy (University of California, Los Angeles medical student and Barrow Global neurosurgery researcher), followed by pledge updates from more than 70 stakeholders spanning neurosurgeons, researchers, industry leaders, and policymakers.

Dr. Nicole Perez, Dr. Mohammad Ali Aziz-Sultan, and Noor Alesawy at the Boston Declaration
Nicole A. Pérez, MD, (right), Harvard Medical School alumna and now a PGY-1 Barrow neurosurgery resident who led stakeholder engagement for the Boston Declaration, with Mohammad Ali Aziz-Sultan, MD, (center) and UCLA medical school and fellow Boston Declaration Steering Committee member and Barrow Global neurosurgery researcher Noor Alesawy.

The Boston Declaration follow-up meeting preceded both the Second World Federation of Neurosurgical Societies International Global Neurosurgery Conference and the inaugural meeting of the International Society for Global Neurosurgery (ISGNS), both hosted by the Tanzania Neurosurgical Society. Her Excellency President Samia Suluhu Hassan of Tanzania delivered opening remarks, acknowledging progress made in expanding access to neurosurgical care within the country while underscoring the need for continued effort.

A milestone of the gathering was the formal launch of the ISGNS, with elections held for its inaugural leadership. Dr. Park was elected President for the society’s first two-year term, and Barrow Adjunct Professor Dr. Rosseau will follow his tenure as President-Elect. The establishment of the ISGNS represents a deliberate next step envisioned by the Boston Declaration Steering Committee: the creation of a permanent institutional framework to support coordination, progress tracking, and long-term governance of global neurosurgery initiatives. This transition from a time-limited declaration to a structured organization is designed to ensure continuity in reporting, foster cross-stakeholder collaboration, and provide a centralized platform for monitoring pledge fulfillment over time.

Members of the Barrow Global team attend the Second Annual World Federation of Neurosurgical Societies International Global Neurosurgery Conference in Dar es Salaam, Tanzania, in April 2026. This year’s meeting was held in collaboration with the inaugural International Society of Global Neurosurgery (ISGNS) Conference and marked one year since the Boston Declaration. Her Excellency President Amia Suluhu Hassan of Tanzania (pictured in the middle of the seated row) addressed conference attendees, affirming the country’s commitment to bolstering neurosurgery access and services.

Barrow Neurological Institute contributed 10 pledges across various domains presented by Kerry Vaughan, MD; Cyrus Ellahi, MD; Francisco Rivera, MD; and Noor Alesawy:

  • Establish an international neurosurgery research fellowship
  • Establish a research and education collaboration with Paraguayan neurosurgery leadership
  • Support and sustain an international spine neurosurgery research fellowship
  • Advance economic modeling research with the Thunderbird School of Management at Arizona State University
  • Develop cross-continental collaborations to advance neurosurgical training
  • Sustain a global neurosurgery fellowship program for the academic training of neurosurgeons
  • Sustain and enhance a COSECSA neurosurgery residency in northern Tanzania
  • Expand the funded international neurosurgery and neurology observership program for clinicians from low- and middle-income countries
  • Establish an annual regional neurosurgery training and education symposium in Panama
  • Develop and deliver a “Navigating the Global Neurosurgery Ecosystem” course on SURGhub, the UN Global Surgery Learning Hub, in partnership with the Global Surgery Foundation

At the one-year mark, the Boston Declaration reflects meaningful progress and sustained stakeholder engagement, while reinforcing the continued need for coordinated, long-term commitment to equitable neurosurgical care worldwide.

Birds-eye view of the inside of the Edward M. Kennedy Institute, where the Boston Declaration was held.
A look inside the Edward M. Kennedy Institute, where the Boston Declaration was held.
Dr. Lawton at the microphone at the Boston Declaration
Barrow President and CEO Michael T. Lawton, MD, speaks at the Boston Declaration.
Chibueze Agwu presents at Boston Declaration. Behind him is a map of the world and the Barrow Global logo.
During the Boston Declaration, former Barrow Global medical student scholar and current Stanford Medicine general surgery intern Chibueze Agwu, MD, presents a pledge from Barrow to establish and expand a funded international observership program at Barrow for candidates from low- and middle-income countries.
Birds-eye view of the audience at the WFNS/ISGNS global neurosurgery meeting
A birds-eye view of the audience at the joint WFNS International Global Neurosurgery and inaugural ISGNS Conference
Her Excellency President Amia Suluhu Hassan of Tanzania holds up a plaque in front of the audience at a global neurosurgery conference
Her Excellency President Amia Suluhu Hassan of Tanzania confirms the country’s commitment to neurosurgery while at the WFNS/ISGNS Conference.
Tanzania president speaks to audience at WFNS/ISGNS Conference
Her Excellency President Amia Suluhu Hassan of Tanzania addresses the audience at the WFNS/ISGNS Conference.
Tanzania president addresses audience at WFNS/ISGNS Conference.
Her Excellency President Amia Suluhu Hassan of Tanzania addresses the audience at the WFNS/ISGNS Conference.
Dr. Goodluck Ndibalema presents on stage at the WFNS/ISGNS Conference
Dr. Goodluck Ndibalema, a neurosurgery resident at KCMC, presents an update at the WFNS/ISGNS Conference.
Dr. Robert Dempsey presents FIENS pledge at the WFNS/ISGNS Conference
Robert J. Dempsey, MD, the Manucher Javid Professor and Chairman of Neurological Surgery at the University of Wisconsin School of Medicine and Public Health, presents an update on the FIENS pledge at the WFNS/ISGNS Conference.
Boston Declaration Steering Committee and President of Tanzanian Neurosurgical Society
From left: President of the Tanzanian Neurosurgical Society Hamisi Shabani, MD, PhD, with Boston Declaration Steering Committee members Kee Park, MD; Noor Alesawy; and Gail Rosseau, MD.
Dr. Kerry Vaughan addresses the WFNS/ISGNS Conference
Barrow Global Africa Site Director Kerry Vaughan, MD, addresses the audience at the WFNS/ISGNS Conference.
Executive Board of the International Society of Global Neurosurgery standing in front of conference signage
The inaugural Executive Board of the ISGNS is pictured at the WFNS/ISGNS Conference. From left: Executive Director Jay Bay; President-Elect Dr. Gail Rosseau; Past President Dr. Tariq Khan, President Dr. Kee Park, Vice President Dr. Beverly Cheserem, Director-at-Large Dr. Hamisi Shabani, Treasurer Dr Eylem Ocal, and Director-at-Large Dr. Kemal Gotme. Not pictured: Secretary Dr. Happiness Rabiel.

Top photo: Dr. Rosseau delivers opening remarks at the Boston Declaration.

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