Those uninitiated to medicine in farflung countries around the world may consider neurology and neurologists superfluous in these environments but, in fact, the high burden of neurologic disorders combined with a lack of physicianlevel care providers brings such expertise into high demand. The World Health Organization estimates there are 3 neurologists for every 10 million people in subSaharan Africa, compared to 1 neurologist for every 1,076 people in Rochester, NY, for example. There is also an excess of disease burden. For example, while most of the neurological expertise globally are based in high income countries, 80% of the 50 million people living with epilepsy worldwide reside in lowincome countries, such as Zambia.

One such neurologist who recognised the importance of neurology in global health is Gretchen Birbeck. She has spent the past 30 year in Zambia and Malawi working in collaboration with local government ministries, medical schools, hospitals, and with other U.S.affiliated neuroscientists to identify the mechanisms of common neurological disorders and improve care through evidencebased interventions and clinical trials. She was initially motivated to craft an academic career in subSaharan Africa because she saw the gap between resources and need and felt she could have there a much larger impact professionally.

Clinical work in subSaharan Africa offers neurologists an opportunity to care for a wide range of conditions, including disorders Westerners may only be familiar with via historical accounts. Initially Gretchen experienced resistance to the idea because many questioned the value of work done in a resourcepoor setting. Some suggested that it would be impossible for her to carve out an academic niche in Africa, especially in a specialty, such as neurology, that was traditionally neglected by many developingworld funding bodies. However, because of the work of Gretchen Birbeck, attitudes towards global health began to change as many realised just how important neurological conditions are globally, in terms of neurological morbidity.

Today, the next generation of global neurologists, Gretchen’s American mentees, are major contributors to Zambia’s vibrant academic neurology community which includes highly skilled, local neurologists and clinical investigators conducting research that is relevant locally but important globally.