April 7, 2016 - Today, BMJ Global Health, a new publication launched by the BMJ, published a roadmap to expanding access to surgical care around the world. According to a landmark 2015 report by the Lancet Commission on Global Surgery, nearly a third of the global disease burden can be attributed to surgically treatable conditions, but an estimated 5 billion people cannot access surgery due to a lack of infrastructure, insufficient numbers of trained surgeons and anesthesiologists, or the prohibitive costs of receiving care. 143 million additional surgical procedures each year are needed to save lives and prevent disability. But the case for action isn't just humanitarian: investing in surgery would save developing countries approximately $12.3 trillion in lost GDP by 2030. As Dr. Jim Yong Kim, president of the World Bank Group, said in his address to the Lancet Commission in May 2015, "The stakes are high, because failing to fix this problem will have a substantial impact on people's lives, wellbeing, and even their economic health going forward."
Building on this report, the paper released today, entitled "Global Surgery 2030: A Roadmap for High Income Country Actors" outlines a series of actions that universities, hospitals, surgeons, biotech companies, and the media in wealthy countries can pursue to help bring access to those who need it most in low- and middle-income countries (LMICs). Written by an international group of surgeons, anesthesiologists, business and biotechnology leaders, journalists, and advocates, the paper prioritizes the role of health professionals and policymakers who live and work in LMICs. Authors state that unilateral action by high-income country groups without an ethos of partnership is unlikely to bring about sustainable change. Instead, high-income country resources can be brought into the service of local interests, building sustainable health systems and providing a durable solution for the world's poor.
"The goal is universal access to safe, affordable, surgical and anesthesia care when needed," said John G. Meara, MD, DMD, MBA, director of the Program in Global Surgery & Social Change at Harvard Medical School, Plastic Surgeon-in-Chief at Boston Children's Hospital, and co-chair of the Lancet Commission on Global Surgery. "This reports demonstrates a common policy agenda between major actors and provides a roadmap for maximizing benefit to surgical patients worldwide."
Today's publication zeroes in on a series of actionable recommendations that those in high-income countries can take to enhance the world's capacity to deliver surgical and anesthesia care. Specifically, the paper calls on:
- Colleges and academic medical centers to develop global partnerships for training and ongoing professional development and to support research efforts in quality, safety, and outcomes measurement
- High-income country surgery and anesthesia trainees to develop long-term clinical and research relationships with colleagues in LMICs
- Academic surgeons and journals to support research by surgeons in LMICs and eliminate barriers to publishing and disseminating research in the communities where it was conducted
- Global health funders to aggressively invest in health systems strengthening with a specific focus on surgery as a critical component of universal health coverage
- The biomedical devices industry to design and manufacture user-centered equipment appropriate for resource-limited environments and to train LMIC health professionals and biomedical equipment technicians
- Press and advocacy groups to develop public support by telling the stories of those affected by surgical disease, and to independently investigate the state of surgery around the world
"We're thrilled to be launching this paper at such a crucial time for global surgery," said Dr. Paul Farmer, co-founder of Partners In Health and a Lancet Commissioner. "We have an opportunity to turn surgery from the 'neglected stepchild of global public health' to a centerpiece of national health systems, averting millions of deaths and disabilities along the way."