International organisations in global surgery: challenges and opportunities

Abstract

Abstract: Over the past decades, single disease programs have garnered significant international attention. In contrast, surgical care has been afforded low priority in some of the world’s poorest regions, leaving 5 billion people living without access to safe surgical care. The Lancet Commission on Global Surgery was the first of its kind to shine a light on the gross disparities in surgical access around the world, and called for the coordinated, sustainable, solution-orientated efforts of the global network to ensure universal access to safe, timely and affordable surgical, obstetric and anesthesia (SOA) care. With that, the Global Surgery movement began. This paper explore the roles played thus far by international organisations in the Global Surgery movement, including the World Health Organisation, UNITAR, UNICEF, the World Bank and the regional blocs. Prior to the Commission, the WHO had already initiated efforts to strengthen surgical access and quality improvement by establishing the Emergency and Essential Surgical Care (EESC) Programme, and developing the Surgical Safety checklist, Patient Safety Pulse Oximetry Project, Safe Childbirth checklist, Guidelines for Essential Trauma Care and Standards for Surveillance of Neuro-trauma. Since the Commission, the larger global community began to engage with the initial adoption of the global surgical indicators into the World Bank Indicators, development of the 3rd edition of the Disease Control Priorities, and regional participation in the development of National Surgical, Obstetric and Anesthesia Plans. But as the initial fervour settles, the Global Surgery movement now faces challenges in capturing the public attention, driving national, regional and global participation in ensuring surgical access, and addressing the constrained fiscal space. COVID-19 may appear to pose a new challenge, however this can still be an opportunity. With a shifting global focus on health systems strengthening, international organisations have chance to incorporate surgical systems strengthening as component of pandemic preparedness and reaffirming their commitment to advancing Global Surgery, so it may realize its vision of universal access to safe, timely, affordable surgical and anesthesia care for all.

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