Increasing surgical capacity in the global South

Written on 08 February 2018 by:
Piotr Gierszewski
Piotr Gierszewski
Olivier Usher
Olivier Usher
Shannon Harmon
Shannon Harmon

The surgical capacity of the developing world is low. There is roughly one surgeon per 200,000 people on average, and five times fewer than this within Sub-Saharan Africa alone. For comparison, Austria has almost 196 surgeons per 200,000 people.

Hospitals often do not have running water, stable sources of electricity or access to roads. Resource shortages mean that crucial equipment and supplies are either reused or unavailable leading to a lack of critical elements of surgical care, such as anaesthesia.

Surgeons leaving their home country to study abroad will often train using equipment that will not be available to them locally – and many will decide not to go back home.

All of these instances and more create barriers to accessing safe and reliable surgery.

Until recently, the challenges of accessing surgical care were not recognised as significant contributors to the global disease burden and were not a top priority in the eyes of health agencies.

Thanks to the Lancet Commission on Global Surgery – which reports that five billion people lack access to safe and affordable surgical services – the issues of surgical equity are being brought forward as a main element of the universal health coverage, an initiative which advocates for giving all individuals and communities safe and affordable access to essential health services.

Figures vary, but the WHO estimates that there were 16.9 million premature deaths due to a lack of safe surgical care in 2010. Even more conservative estimates still exceed the combined mortality rates of HIV/AIDS, tuberculosis and malaria. The Lancet report also reports that the economic productivity of low and middle-income countries will be weaker by $12.3 trillion between 2015-2030 due to unmet surgical need.

We want to bring transformational innovation to surgical challenges in low resource settings.

Nations and specialist NGOs around the globe are doing what they can to increase the surgical workforce. We can support these efforts in other areas ranging from development of better surgical tools and systems design, upskilling personnel and operative care, to new infrastructure, platforms and distribution systems for healthcare provision. With new technologies, approaches and ways of thinking increasing access to safe surgical care can be accelerated and leave a lasting effect on both the wellbeing and robustness of communities around the globe.

Surgical equity at our Summit

At the Challenges of Our Era Summit – to be held in Milan on 6/7 March 2018 – we are bringing together experts and stakeholders to kick-start the design of challenge initiatives improving surgical equity across the global.

We are honoured to be hosting experts and representatives from the medical world alongside Amb. Neil Parsan, president of The G4 Alliance, and Walter Johnson, the director of Emergency and Essential Surgical Care Programme at the WHO. Our introduction will be lead by Tom Weiser (Associate Professor of Surgery, Stanford University) and the programme will also feature Jana MacLeod (Consultant Surgeon & Intensivist-Critical Care, Columbia Africa Medical Center), Emmanuel Makasa (Global Surgery Advocate and Consultant) and Carolina Haylock-Loor (Anesthesiologist and Intensive Care Physician, World Federation of Societies of Anaesthesiologist).

Expert workshops will be the highlight of the Summit. Each delegate will pick one of four surgical topics which will act as a conversation starter with the ultimate goal of influencing the design of this challenge initiative. ​​

The workshops will focus on:

  • ​Postoperative ​infections: How ​can ​we ​minimise ​infections taking place after operations?
  • ​Safe ​anaesthetic ​care: How ​could ​we ​adapt anaesthetic ​machines ​and procedures ​to ​deliver ​better care ​in ​low ​resource ​settings?
  • ​Blood ​banking ​and ​transfusions: How ​to ​increase ​access ​to ​safe blood ​transfusions?
  • ​Operating ​theatre ​technologies: What ​should ​we ​focus ​on ​in improving ​the ​operating ​suite?

For these workshops, we are joining forces with The G4 Alliance, WFSA and Lifebox as content advisors.

Examples of challenge-driven innovation

At Nesta, we believe that challenge-driven innovation is a great way to crowdsource solutions by capturing people’s attention and accelerating progress within the biggest challenges of our time – and global health is no exception.

To date, our biggest prize is the Longitude Prize, which will award a £10 million prize to a team of researchers who come up with a diagnostic test which will help reduce antibiotic resistance. The prize sets out in it’s challenge various criteria such as being affordable, easy to use and accurate, which currently over 250 teams are competing to achieve. We have also recently launched the Mobility Unlimited Challenge with the Toyota Mobility Foundation, a 3-year long challenge with a $4 million prize fund. The Challenge aims to support radical improvements in the mobility and independence of people with lower-limb paralysis.

Register your interest if you are keen to participate in the Surgical Equity workshops. We want to hear from you if you’re a medical professional, policy advisor, medical device innovator, social entrepreneur or someone who is willing to act to give people access to safer surgical and anaesthetic care.