INTRODUCTION:
The
World Health Organization (WHO) together with the Iceland Ministry of
Health and Social Security sponsored a conference entitled “Human Spinal Cord Injury: New and Emerging
Approaches to Treatment” held on May 31
– June 2, 2001 in Reykjavik, Iceland. To help catalyze the development
of new paradigms to address spinal cord injury, the conference’s
overall goal was to bring in a diversity of perspectives, ranging from
state-of-the-art stem cell biology to the ancient wisdom of Eastern
Medicine.
As
a consequence of this meeting, Dr. Gro Harlem Brundtland,
Director-General, WHO has mandated the creation of a WHO Collaborating
Center to be located in Reykjavik, Iceland (see photo). 
The
Center's tentative mission statement is indicated below.
The nascent Center’s underlying philosophy is that
if we can open-mindedly integrate the divergent pieces of the puzzle
that exist throughout the world - whether they originate in the US,
China, Israel, etc., whether they reflect the perspectives of Western
medicine or Eastern or indigenous healing traditions, or whether they
reflect the contributions of large academic medical centers or small
clinics - restoration of function is a real world possibility now and
not just some distant pie-in-the-sky possibility.
Furthermore, the mission statement reflects the
belief that at a global level, SCI is a human-rights issue.
MISSION
STATEMENT
According to the WHO mission statement, ”the
objective of WHO is the attainment by all peoples of the highest
possible levels of health.” The goal of the Icelandic WHO
Collaborating Center is to help fulfill this objective with respect to
spinal cord injury (SCI) by fostering the development of new treatments,
“cures,” and approaches for restoring function after SCI.
Few physical disabilities have as profound of an
impact as SCI. Unlike most neurological disorders that affect the
elderly, SCI frequently afflicts young adults whose societal
contributions have just begun. In
addition to life-altering physiological changes caused by paralysis,
these individuals, who have a near-normal life expectancy, face immense
lifetime SCI-associated expenses that must be shouldered either by the
individual or society. Finally, because people with SCI desire the opportunity to be
meaningfully integrated into society and mankind’s most fundamental
freedom of self-determination, SCI becomes a human-rights issue.
From a human-rights perspective, the Center’s
overall goal is to facilitate the bringing forth of new treatments,
cures, and approaches for restoring function after SCI that will permit
greater personal independence, societal participation, and overall
quality of life. Scientifically,
these approaches will include basic science, clinical research,
assistive and rehabilitative technology, and relevant social policy
research.
Consistent with the WHO published guidelines
“International Classification of Functioning, Disability, and
Health,” the Center recognizes that one can cure problems
faced by people with SCI by improving the person’s physical capacity
or/and changing the environment. The
former involves a spectrum of endpoints, including ambulation, grasping
ability, bowel and bladder control, sexual function, pain and spasticity
reduction, etc., modest improvements of which can often greatly affect
quality of life and independence. The latter involves a diversity of
social issues that provide access to the world we live in, including,
equal opportunity for education and employment, provision of assistive
technologies and personal assistance, accessible transportation and
housing, etc.
Reflecting the diversity inherent in the WHO, the
Center will strive to be as inclusive as possible with respect to the
divergent world thinking for treating the sequelae of SCI. By so doing,
it will attempt to synergistically integrate approaches that have been
developed throughout the world to create new, beneficial knowledge that
is greater than the sum of the components.
Examples of potential Center-facilitated
collaborative emphases include:
 | Creating
an inclusive data-base containing information on SCI research,
therapies, healing modalities and assistive technologies of benefit
to both researchers and health-care consumers. |
| Developing
conferences and workshops facilitating bridge-building
collaborations among SCI scientists, health-care professionals, and
people with SCI |
| Fostering
cross-disciplinary approaches to SCI, for example, combining a
non-biological intervention (e.g., exoskeleton prosthetic) and a
biological intervention (e.g., creating weak walkers as a function
of surgery). |
| Fostering
bench-to-bedside technology-transfer, including clinical and
community trials. |
| Fostering
resource-maximizing relationships, partnerships, and collaborations
between government, non-profit, and for-profit organizations. |
| Building
synergistic collaborations between SCI research endeavors carried
out in different countries. |
| Fostering
the critical evaluation of therapies developed by small, independent
clinics through the establishment of relationships with
research-focused institutions. |
| Fostering
the scientific evaluation of non-Western, albeit often empirically
supported, therapies (e.g., eastern or indigenous healing
traditions) using qualitative research as well as quantitative
research models. |
| Recognizing
that much of the World’s population cannot afford Western
high-technology medicine, fostering the development of approaches
consistent with the unique needs of Third-World or developing
nations. |
| Foster
the evaluation of social policy influences on opportunity
equalization for individuals with SCI in education, employment,
housing, transportation, communication, and economic
self-sufficiency. |
