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Neurosurgeon Benjamin Warf tells House subcommittee about low‑cost surgery and remote training to treat infant hydrocephalus
Summary
Dr. Benjamin Warf described a shunt‑sparing procedure (ETVCPC) developed and validated in Uganda, said it can permanently treat many infants without shunts, and explained NeuroKids' training and remote‑mentoring model to scale the technique in low‑resource countries.
Dr. Benjamin Warf, founder and chairman of the nonprofit NeuroKids and a pediatric neurosurgeon, told a House Foreign Affairs subcommittee that infant hydrocephalus remains common and often fatal in low‑resource countries but is increasingly treatable through a minimally invasive procedure and expanded training.
Warf described the endoscopic third ventriculostomy with choroid plexus cauterization (ETVCPC), which his testimony traces to validation work in Uganda with support from USAID and NIH. He said ETVCPC can eliminate the need for lifelong shunt dependence in about two‑thirds of infants and carries a lower long‑term infection risk than shunts. “A minimally invasive endoscopic brain operation called ETVCPC… can permanently treat infant hydrocephalus without the need for a shunt in around 2 out of 3 infants,” Warf testified.
Warf emphasized prevention and workforce development. He said neonatal infection and neural‑tube defects (spina bifida) account for most hydrocephalus cases in low‑resource settings and noted folate supplementation or fortification could reduce spina bifida incidence by about two‑thirds in affected countries. He also described NeuroKids’ blended training model: remote pre‑site preparation, short hands‑on site visits and ongoing intraoperative remote mentoring using real‑time video links so experienced mentors can guide local surgeons during operations.
Warf reported that early program iterations trained surgeons from roughly 30 countries and that NeuroKids aims to ‘train trainers’ to scale capacity. He also said researchers recently identified a bacterium (named in testimony as Pani bacillus) linked to post‑infectious hydrocephalus in Eastern Uganda, and he called for expanded pathogen surveillance and prevention initiatives.
The subcommittee’s questioning focused on implementation barriers — workforce retention, on‑site resource differences, and the need to adapt training to local contexts — and on how U.S. assistance (NIH, USAID) can support both research and surgical capacity building.
Ending: Warf urged greater U.S. investment in prevention, training and research to reduce mortality and lifelong disability from infant hydrocephalus.
