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Ng-Kamstra JS, Greenberg SLM, Abdullah F, Amado V, Anderson GA, Cossa M, Costas-Chavarri A, Davies J, Debas HT, Dyer GSM, Erdene S, Farmer PE, Gaumnitz A, Hagander L, Haider A, Leather AJM, Lin Y, Marten R, Marvin JT, McClain CD, Meara JG, Meheš M, Mock C, Mukhopadhyay S, Orgoi S, Prestero T, Price RR, Raykar NP, Riesel JN, Riviello R, Rudy SM, Saluja S, Sullivan R, Tarpley JL, Taylor RH, Telemaque LF, Toma G, Varghese A, Walker M, Yamey G, Shrime MG. Global Surgery 2030: a roadmap for high income country actors. BMJ Glob Health 2016; 1:e000011. [PMID: 28588908 PMCID: PMC5321301 DOI: 10.1136/bmjgh-2015-000011] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/06/2016] [Accepted: 01/19/2016] [Indexed: 12/16/2022] Open
Abstract
The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future.
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Affiliation(s)
- Joshua S Ng-Kamstra
- Department of Surgery, University of Toronto, Toronto, Canada
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Sarah L M Greenberg
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Fizan Abdullah
- Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Vanda Amado
- Department of Surgery, Maputo Central Hospital, Maputo, Mozambique
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Geoffrey A Anderson
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Matchecane Cossa
- National Program of Surgery, Ministry of Health of Mozambique, Maputo, Mozambique
| | - Ainhoa Costas-Chavarri
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Haile T Debas
- University of California, San Francisco School of Medicine, San Francisco, California, USA
- University of California Global Health Institute, San Francisco, California, USA
| | - George S M Dyer
- Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sarnai Erdene
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Paul E Farmer
- Harvard University, Cambridge, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | | | - Lars Hagander
- Pediatric Surgery, Department of Clinical Sciences in Lund, Division of Pediatrics, Lund University, Lund, Sweden
| | - Adil Haider
- Center for Surgery and Public Health, Harvard Medical School and Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Andrew J M Leather
- King's Centre for Global Health, King's Health Partners and King's College London, London, UK
| | - Yihan Lin
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, University of Colorado Faculty of Medicine, Denver, Colorado, USA
| | - Robert Marten
- The Rockefeller Foundation, New York, New York, USA
- Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Craig D McClain
- Department of Anaesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - John G Meara
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Mira Meheš
- The G4 Alliance, New York, New York, USA
| | - Charles Mock
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Global Injury Section, Harborview Injury Prevention and Research Centre, Seattle, Washington, USA
| | - Swagoto Mukhopadhyay
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- University of Connecticut School of Medicine Integrated General Surgery Program, Farmington, Connecticut, USA
| | - Sergelen Orgoi
- Department of Surgery, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- WHO Collaborating Centre for Essential Emergency and Surgical Care (MOG1), Ulaanbaatar, Mongolia
| | | | - Raymond R Price
- Department of Surgery, Center for Global Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Intermountain Surgical Specialists, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Nakul P Raykar
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Beth Israel Deaconess Medical Centre, Boston, Massachusetts, USA
| | - Johanna N Riesel
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Plastic Surgery Combined Residency Program, Boston, Massachusetts, USA
| | - Robert Riviello
- Center for Surgery and Public Health, Harvard Medical School and Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
- Division of Trauma, Burns, and Surgical Critical Care, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Saurabh Saluja
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Richard Sullivan
- King's Centre for Global Health, King's Health Partners and King's College London, London, UK
- Institute of Cancer Policy, King's College London, London, UK
| | - John L Tarpley
- Department of Surgery, Section of Surgical Sciences, Vanderbilt University, Nashville, Tennessee, USA
- Surgical Service, VA Tennessee Valley Health Care System, Nashville, USA
| | - Robert H Taylor
- Department of Surgery, Branch for International Surgical Care, University of British Columbia, Vancouver, Canada
| | - Louis-Franck Telemaque
- Department of Surgery, State Medical School, Port-au-Prince, Haiti
- State University Hospital, Port-au-Prince, Haiti
| | - Gabriel Toma
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
| | - Asha Varghese
- Developing Health Globally, GE Foundation, Fairfield, Connecticut, USA
| | - Melanie Walker
- President's Delivery Unit, World Bank Group, Washington DC, USA
| | - Gavin Yamey
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Mark G Shrime
- Program in Global Surgery and Social Change, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Otology and Laryngology and Office of Global Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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