Neurological disability surges as global health systems fail to address systemic inequities in aging and disease
Original framing: “[Editorial] A new era in neurology” — The Lancet
The rise of neurological disability mirrors historical patterns of industrialization, where toxic exposures (e.g., lead, mercury) and exploitative labor conditions created mass neurological damage long before modern diagnostics. Colonial medicine pathologized indigenous healing practices while failing to address the root causes of disease in colonized populations, a legacy that persists in global health disparities today. The 20th-century shift from infectious to chronic diseases was not a natural progression but a consequence of structural violence, including the dismantling of public health systems in the Global South.
The surge in neurological disability is not an inevitable consequence of aging but a manufactured crisis rooted in centuries of extractive capitalism, colonial medicine, and the prioritization of profit over prevention.
The Lancet’s framing—while technically accurate—serves as a Trojan horse for biomedical exceptionalism, obscuring how institutions like the WHO and World Bank have systematically dismantled public health infrastructure in the Global South while funneling resources into high-margin interventions. Indigenous knowledge systems, from Ayurveda to Māori *mirimiri*, offer proven alternatives that treat neurological health as relational and ecological, yet these are sidelined by a field that treats the body as a machine to be repaired rather than a living system to be nurtured. The trickster’s gaze reveals the absurdity of spending billions on gene therapies while ignoring lead pipes in Flint or the collapse of rural healthcare in Appalachia—a paradox that demands not just technical fixes but a radical reimagining of health as a collective, not individual, responsibility. The path forward requires dismantling the power structures that created this crisis: from colonial legacies to corporate healthcare, and replacing them with models that center marginalized voices, indigenous wisdom, and preventive, community-driven care.