We need 143 million additional surgeries each year in lower and middle income countries

One third of human disease requires surgery. And yet surgical inequity is not yet high on the agenda of international institutions, ministries of health and finance, development agencies and bilateral, multilateral and private funders.

Until recently, surgery was not recognised as a significant contributor to the global disease burden and was not a top priority in the eyes of global public health agencies.

But recent estimates from The Lancet claim that five billion people lack access to safe and affordable surgical services.

We need to change this.

We believe there is an urgent need to develop more adaptable low-cost surgical tools and better system design, support and services that fit into different environments. We also need to upskill personnel, improve hospital infrastructure and build more reliable distribution and supply systems for operating theatre provision.

Prizes Are powerful Tools that help create Long-term Solutions To Some of the biggest challenges we face.

For this reason, we are designing a Challenge Prize as part of a broader campaign to raise awareness, leverage knowledge and expertise, and harness the requisite technical and financial resources.

Lack of action in improving surgery and anaesthesia could imperil our collective effort to realise several SDGs. For example, if access to caesarean section is not dramatically improved, it is doubtful that SDG 3.1, which calls for a reduction in the global maternal mortality ratio to less than 70 per 100,000 live births, can be realised. 

An opportunity for real change

Redesigning surgery around local resources

Let’s redesign surgical care in poorer countries from the ground up instead of trying to adapt the solutions found elsewhere. We should use local talent, transport links and build upon existing resources to create  materials, tools, and approaches to surgery that are innovative and suitable for local communities.

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Key messages

● In 2010, 16.9 million lives were lost from conditions requiring surgical care, a figure that exceeds the mortality rates of HIV/AIDS, tuberculosis and malaria combined
● There are roughly 0.5 surgeons per 100,000 people in the developing world and five times fewer within of sub-Saharan Africa. For comparison, Austria has almost 98 surgeons per 100,000
● Meeting the majority of the 16 health-related SDGs, including Universal Health Coverage, requires significant investment in improving access and safety of surgical services.

Local Adaptations

Rural hospitals often do not have running water, stable electricity sources, or access to roads. Resource shortages mean that crucial equipment and supplies (such as medical oxygen) are either reused or unavailable, anaesthesia cannot be provided, and hospitals depend on the help of non-specialists.

Financial Barriers

Seeking surgical care has disastrous financial consequences for over 80 million people and their families  every year, nearly 60 percent of whom face ‘catastrophic health expenditure’ due to non-medical costs, such as reaching the surgery in the first place.

Challenge Prizes

The Challenge Prize Centre at Nesta wants to steer the discussion towards improving the access to and capacity for surgery in developing countries. Prizes are powerful tools for incentivising the creation of long-term solutions to social challenges by stimulating new enterprise and endeavour.

In this regard, we are looking to collaborate with organisations to deploy challenge prizes as a tool to foster and generate innovation to widen access to surgery and improve its quality in LMICs.

Potential Key Challenges:

  1. Post-operative infections
  2. Safe anaesthetic monitoring and administration
  3. Blood banking and transfusions
  4. Procurement, integration and intelligent theatre technology
5 billion people cannot get safe and affordable surgical and anaesthesia care, 90% of people in LMICs can’t even get basic surgical care.
— Jim Yong Kim MD, PhD 12th President of the The World Bank
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