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Forging Ahead: Bridging Gaps in Global Surgery
9-11th July 2025,
Hilton Kota Kinabalu, Sabah
Azmi bin Alias
Dr Azmi Alias currently is the Head of Neurosurgery Service for Ministry of Health of Malaysia. He works as the Head Department and Senior Consultant Neurosurgeon at Department of Neurosurgery, Tunku Abdul Rahman Neuroscience Institute (IKTAR), Hospital Kuala Lumpur.
He is also an honorary Lecturer for the Post Graduate Training Master of Neurosurgery, Universiti Sains Malaysia, University of Malaya and Universiti Kebangsaan Malaysia, chairman of National Safe Surgery Saves Lives Steering committee, member of national POMR committee, Medical Qualifying Committee ( Neurosurgery) of Malaysian Medical Council, trainer for the MOH Quality Assurance and Quality Improvement and council member of College of Surgeons, Academy of Medicine of Malaysia.
He is the secretary General of International Society for Minimally Invasive Techniques in Neurosurgery (ISMINS), board member of ACNS and Asia Pacific Society of Endoscopic Neurosurgery, active members of World Academy of Neurological Surgery (WANS), International Society for Pediatric Neurosurgery (ISPN) and former Vice President of the Asian Australasian Society for Neurological Surgeons (AASNS) and Nominating Commitee of the World Federation of Neurosurgical Societies (WFNS).
He obtained his medical degree from University of Malaya in 1994, Master of Surgery (General) from Universiti Kebangsaan Malaysia in 2001 and pursued MOH subspecialty training in Neurosurgery in Tunku Abdul Rahman Neuroscience Institute and visiting fellowship in University of Mainz, Germany and Women Children Hospital, Adelaide Australia.
Abstract
Traumatic brain injury (TBI) and hemorrhagic stroke are critical neurosurgical emergencies that demand timely intervention to reduce mortality and long-term disability. In Malaysia, a high middle-income country with a dual healthcare system (public and private sectors), access to essential neurosurgical care remains uneven, particularly in rural and underserved regions. This paper explores the challenges and opportunities in delivering equitable neurosurgical care for TBI and haemorrhagic stroke within the global surgery framework, emphasizing resource limitations, workforce distribution, and systemic barriers.
Key challenges include geographic disparities in access to neurosurgical expertise, shortages of trained neurosurgeons, equipment and critical care facilities, and financial constraints in emergency neurosurgical management. Despite these hurdles, Malaysia has made strides in improving neurosurgical capacity through decentralized management by implementing cluster hospital initiatives, opening new centres at targeted location, increasing training post in conjoined board, training development in area of interest, telemedicine for remote consultations and public health policies aimed at reducing stroke burden.
From a global surgery perspective, strengthening prehospital care, investing in training for emergency neurosurgical procedures, and expanding telemedicine for remote consultations could enhance outcomes. Collaborative efforts between government, academic institutions, and international partners are essential to align with the World Health Organization’s (WHO) goals for emergency and essential surgical care. Addressing these gaps will not only improve survival and functional recovery for TBI and stroke patients but also serve as a model for neurosurgical care delivery in similar resource-variable settings