Authors: Luke Caddell and Rolvix Patterson
“No country can achieve Universal Health Coverage unless its people have access to safe, timely, and affordable surgical services… It’s therefore vital that countries invest in surgery." Dr. Tedros Adhonam, Director-General of the World Health Organization (WHO)
In collaboration with Harvard Medical School Center for Global Health Delivery–Dubai, the PGSSC coordinated the meeting of a diverse group of 77 stakeholders in Dubai, United Arab Emirates from March 20-21, 2019 for a National Surgical, Obstetrics, and Anesthesia Planning Conference. Representatives attended from the Western Pacific, Africa and Asia regions, the World Bank, the WHO, and other multilateral agencies. The burden of disease due to inadequate access to surgery is staggering; it has been estimated that approximately 17 million die annually due to conditions that require surgery. In response to this need, the conference participants used a research and policy lens to explore the role of surgery, anesthesia, and obstetrics in achieving Sustainable Development Goal (SDG) 3 in pursuit of Universal Health Coverage (UHC).
The conference primarily focused on the development, funding and implementation of national surgical policies called National Surgical, Obstetric, and Anesthesia Plans (NSOAPs). These country-driven policies are created through a collaborative stakeholder process, and they are intended to augment national health plans by providing baseline data on surgical system functioning and a comprehensive strategy for increasing surgical capacity within a country. Participants shared their unique perspectives on the current status of surgery, obstetric, and anesthesia system strengthening, and they contributed to a vision of improved surgery for all across the world. Panels describing regional efforts, global health funding, and World Health Organization collaboration answered questions from the attendees to help break down the silos which have traditional divided these groups.
This conference coincided with rapidly-increasing commitments to national surgical planning across the globe. Recently, the 16 member states of the South African Development Community pledged to pursue national surgical planning. Similar regional movements have gained momentum in the West African College of Surgeons community and the Western Pacific, which is the first region to successfully collect all of the Lancet Commission on Global Surgery indicators. Stakeholders built the growing momentum for national surgical planning by acknowledging the need for further NSOAP development and financing to achieve health and equity goals. Furthermore, the discussion provided insight into innovative financing mechanisms to support NSOAP implementation, and it outlined next steps for the Western Pacific and Asia regions, specifically.
These health care leaders gained an understanding of the known burden of surgical conditions and the importance of reporting surgical metrics on national and regional levels. Furthermore, they were equipped with knowledge of a potential policy solution that can ensure surgical, obstetric, and anesthesia care throughout their countries and regions. Paired with continued collaboration around innovation and financing mechanisms, this experience provided participants of the 2019 National Surgical, Obstetric, and Anesthesia Planning Conference with the tools to begin transforming surgical care in their countries.
Facilitating meetings such as this National Surgical, Obstetric, and Anesthesia Planning Conference are key to building the collaborative space needed to implement the kind of intersectoral, horizontal policies that addressing the surgical burden of disease requires. Bringing together diverse stakeholders from governmental, health professional, funding, and multilateral organizations to focus on the issue of perioperative care, the PGSSC hopes to foment opportunities to improve surgical systems through conversations and partnerships among the various actors. The commitments expressed in the executive summary demonstrate the impact of this approach.