Exploring the challenges, innovations, and future of neurosurgical care across the African continent
Neurosurgery, the medical specialty focused on treating the delicate and complex human nervous system, faces some of its greatest challenges and opportunities in Africa. The continent bears over 15% of the global neurosurgical disease burden, yet struggles with a critical shortage of specialists—in some regions, a single neurosurgeon serves over 2.2 million people . This disparity highlights an urgent healthcare crisis, yet also reveals remarkable stories of innovation, collaboration, and resilience. From ancient Egyptian practices to modern telemedicine, African neurosurgery is undergoing a transformative journey to bring life-saving care to millions who would otherwise go without.
Neurosurgery's roots in Africa run deep, with evidence of early procedures dating back thousands of years.
Believed to be written by Egyptian physician Imhotep, contains the first recorded neurosurgical procedures and demonstrates surprisingly advanced knowledge of the nervous system 9 . Describes traction for spinal injuries and reveals early understanding of the relationship between brain injuries and contralateral body paralysis.
Became a pioneering center for neuroanatomy where physicians like Herophilus and Erasistratus conducted systematic dissections, differentiated between sensory and motor nerves, and traced nerve pathways to the brain 9 .
Modern neurosurgery returned to Africa through colonization with departments initially staffed by foreign neurosurgeons 9 . The challenge of "brain drain" emerged early, as the first generation of African neurosurgeons trained abroad often did not return due to limited equipment and poor working conditions 9 .
Neurosurgeons serving 1.3 billion people across Africa 7
Ratio of neurosurgeons to population 7
People served by a single neurosurgeon in some regions
~756 Neurosurgeons (64.4% of total)
Most favorable ratio
409 Neurosurgeons combined
~2.2 million people per neurosurgeon
The problem is compounded by unreliable maintenance culture and insufficient funding for equipment upkeep, further limiting the capacity of available neurosurgeons to provide comprehensive care 2 .
Programs in Malawi, Mozambique, and Uganda train non-physicians to perform life-saving surgeries, helping to expand the surgical workforce .
Between high-income and low-middle-income countries combine online training with periodic hands-on sessions 5 .
Scheduled for May 2025 in Tanzania represents a significant milestone in continental neurosurgical education 4 .
Like those established by WACS and COSECSA work to standardize and improve training quality 7 .
Allow neurosurgeons to evaluate patient cases, review medical images, and provide expert guidance to local healthcare providers 3 .
Has significantly reduced improper inter-hospital transfers by enabling specialist interpretation of scans from remote locations 3 .
Provide continuous professional development for neurosurgeons in remote areas, helping them stay current with advancements 3 .
Despite these advances, challenges remain in implementing telemedicine widely, including poor communication infrastructure, limited electricity access, and sociocultural barriers to adopting new technologies 3 .
African neurosurgical research has seen notable growth in recent years, though significant gaps remain. An analysis of 982 neurosurgical articles by African authors reveals important patterns:
First authors of neurosurgical research were predominantly from Egypt (32.4%), Morocco (15%), and Nigeria (14.2%), indicating varying research capacity across the continent 6 .
Meeting Africa's neurosurgical needs requires substantial scaling of training efforts. Current projections indicate that at present growth rates, Africa will have between 2,716 and 3,813 neurosurgeons by 2030, leaving a deficit of 4,795 to 11,953 specialists 7 .
Despite the significant challenges, the future of African neurosurgery shows promising signs of progress. Upcoming events like the 32nd SNSA Congress in August 2025 in Durban—held in collaboration with the Neurosurgical Society of Australasia—demonstrate growing international engagement and knowledge exchange 1 8 .
The journey toward equitable neurosurgical care across Africa will require sustained commitment from governments, international partners, and the global neurosurgical community. By building on current momentum, embracing innovative approaches, and fostering local leadership, Africa can transform its neurosurgical landscape to ensure that all patients, regardless of location, can access the life-saving care they need.
From its ancient origins to its contemporary challenges, African neurosurgery represents a field of both profound struggle and extraordinary innovation—a testament to the dedication of healthcare professionals working against formidable odds to bring healing and hope to millions.