The Necessity of Diplomacy in Brain Health

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The Lancet Neurology

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Maintaining brain health is arguably one of the greatest global health challenges of the 21st century, as few other issues will have a similar effect on humanity. Given the breadth of factors affecting brain health, we believe that large-scale diplomacy is necessary. Diplomacy is traditionally described as a formal exchange between countries, such as trade talks or negotiations to avoid armed conflict, carried out by formal representatives of nations (eg, emissaries and ambassadors). Yet, the field of diplomacy is far more nuanced, and the way in which diplomacy affects humanity, including health, is informed by a broader understanding of the topic. Large-scale diplomatic activities might include efforts to coordinate research across nations or the establishment of treaties (for example, to reduce air pollution). Activities of this type help to coordinate international projects in research, advocacy, clinical care, consumer participation, innovation, and public health. At an individual level, threats to brain health include neurodevelopmental and neurodegenerative disorders, trauma (physical and psychological), unsafe living or working conditions, poor diet, environmental risk factors, and inadequate access to health care, as well as chronic and often multimorbid conditions, such as hypertension and diabetes. At the community level, risk factors include social isolation, low educational attainment, inconsistent health-care coverage, low socioeconomic status, violent crime, and contaminants and air pollution. At a macro level, the global challenges include climate change, population ageing, rising economic inequality, rural-to-urban migration and megacities with disrupted social safety nets, armed conflicts, mass migration, and the mass digitalisation of life. We propose a brain-health diplomacy model to transcend disciplinary boundaries, and mobilise resources at sufficient scale to improve brain health. This model builds on several theoretical approaches, including health diplomacy, science diplomacy, innovation diplomacy, and convergence science.


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