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Raising the Profile of International Surgical Care The Lancet Commission Report's Implications for resurge

In 2013, a group of surgeons led primarily by Dr. John Meara, Harvard Medical School's Kletjian professor of global surgery and plastic surgeon-in-chief of Boston Children’s Hospital, approached the Lancet, a long-established, well-regarded peer-reviewed medical journal, about the need for surgical care in global health.

According to Dr. Meara, "We want surgery to be part of the discourse on global health, and we want surgery integrated into the discussions about how you build health systems." In response, The Lancet opened a Commission on Global Surgery. The commission’s 25 members collaborated with professional societies, government agencies, non-governmental organizations, and academic institutions in more than 110 countries. Their expertise spans fields including surgery, anesthesia, obstetrics, oncology, health care policy, financing, economics, and research.

The Lancet Commission’s peer-reviewed landmark report, Global Surgery 2030: Evidence and Solutions for Achieving Health, Welfare, and Economic Development, published in April 2015, was the result of 18 months of literature reviews, interviews, online surveys, public consultations with international stakeholders and new primary research examining the state of surgical care around the world.

The report outlined five key messages:

  • Key Message #1: 5 billion people lack access to safe, affordable surgical and anesthesia care when needed. The report defined four dimensions of access – timeliness, surgical capacity, safety, and affordability.
  • Key Message #2: Performance of a minimum of 143 million additional surgical procedures is necessary each year to save lives and prevent disability. This need is greatest in the poorest regions of the world, including Western, Eastern, and Central sub-Saharan Africa, and South and Southeast Asia
  • Key Message #3: 33 million individuals face catastrophic health expenditure due to payment for surgery and anesthesia each year. An additional 48 million cases occur each year when non-medical costs, such as food and transportation expenses, are included
  • Key Message #4: Investment in surgical and anesthesia services is affordable, saves lives, and promotes economic growth. Although the financial cost of surgical expansion is significant, the cost of inaction is much greater. The lost output (total GDP losses) will cost LMICs a total of $12.3 trillion dollars
  • Key Message #5: Surgery is an indivisible, indispensable part of health care

For nearly 50 years, ReSurge has seen that the international need for surgical care is great, and that surgery has a transformative effect on patients’ lives, enabling them to work and live in ways that contribute to their own, and society’s, economic growth. Now, the findings of the Lancet Commission document at scale what ReSurge has long known.

Global Surgery 2030 and similar reports, such as the World Bank’s DCP3 (Disease Control Priorities ) have some important implications for ReSurge.

  • They document the regions and countries with the greatest need for the services we provide
  • They clearly demonstrate the need for a multi-faceted approach to surgical care—one that prioritizes the development of a local surgical workforce in the countries with a need for surgical care
  • They lay out a set of standards for the delivery of safe surgical and anesthesia care than can serve as a guide for our programs

As a result of the important findings of the Lancet Commission report, we are expanding our strategy to include a greater focus on training in the countries we serve, as well as advocacy to generate political priority for surgical care. We are also examining standards to determine a roadmap for incorporating them into our programs.

We are thrilled at the way surgical care is becoming a priority in international public heath and at the way this higher profile is mobilizing support for our work!

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