The rural hospital where Endalew gave birth benefited from programs run by Safe Surgery 2020, an initiative funded in part by the GE Foundation. Image credit: Jhpiego/Karen Kamauski.
The global health world periodically has rude awakenings that expose vulnerabilities in countries’ preparedness to handle health crises. The outbreaks of Ebola and Zika in recent years are a glaring example of this weakness, exposing how poorly prepared areas like West Africa were for threats of that magnitude. Governments, civil society, and the private sector leapt into action with the resources to help, but their aid arrived late and was not completely organized, rendering their relationships and resources underutilized. The next global emergency is always lurking around the corner, making advance preparation of key resources all that much more important.
Global safe surgery is that “next” global emergency, but it is actually already here. The crisis at its core concerns the five billion people globally that lack access to safe surgery – everything from a trained medical staff of surgeons and nurses to accessible facilities with operational surgical equipment and adequate anesthesia. The crisis poses a variety of safety concerns and is hitting the world’s most vulnerable people, low- and middle-income countries (LMICs), the hardest. Simple and common procedures like C-sections are taken for granted in the developed world, but are largely inaccessible or unsafe for many people in developing countries.
To illustrate, an expectant mother in sub-Saharan Africa typically does not have access to life-saving procedures like C-sections if complications arise in her pregnancy. In Nigeria, only 2% of babies are born by C-section due to lack of access to safe procedures, and for every 100,000 live births in the country, 814 women die. The Lancet’s “Global Surgery 2030” report published that 143 million additional surgical procedures are needed in LMICs each year to save lives and prevent disability.[i] This is not only a crisis of similar magnitude to Zika and other natural disasters, but also one that stands to benefit the most from engagement and action by one group in particular – the private sector.
The world, specifically the global health community, is at a critical juncture or watershed moment for safe surgery and requires collaborative action to address the unmet needs of the surgical ecosystem. And private industry has the resources and expertise to address challenges that prevent access to safe surgery. During the 2015 UN General Assembly, GE Foundation helped launch Safe Surgery 2020, a multi-stakeholder initiative to increase access to safe surgery in underserved areas by building leadership on the ground, testing and scaling innovation, and elevating safe surgery’s profile on the global stage.
Improving surgical training, capacity and outcomes
With our partners, Safe Surgery 2020 has driven extraordinary progress over the past three years. Through our national surgical planning program, we supported governments to prioritize surgery, identify gaps in surgical care and mobilize resources. Through our work in Ethiopia and Tanzania, we have developed, tested, and refined our training program to create a package which transforms district hospitals; for example, hospitals have increased surgical volume by 50% and decreased mortality and infection rates by up to a third. Reaching over 900 workers already, our program empowers surgical teams to work well together, follow best practices like the safe surgery checklist, better repair and sterilize surgical equipment and tools, and improve skills such as anesthesia provision. Our work at GE Foundation is but one example. There are other industry leaders engaged in safe surgery initiatives, but we need more and we need better collaboration.
Catalyzing the private sector
In 2016, GE Foundation worked with Johnson & Johnson and founded a private sector coalition called the Private Sector Roundtable (PSRT). The PRST is a growing partnership currently comprised of more than 20 companies from across industries serving as the central touchpoint for private sector actors interested in engaging in global health security. To date, the PSRT, through the work of Qlik and Intel, has delivered a powerful dashboard to track the capabilities of individual countries relative to pandemic and to map their gaps to the specific resources available with the private sector community. As well, the PSRT is currently partnering with Uganda to develop a plan to close its gaps in global health security. This model is easily replicable and deployed for safe surgery and other system strengthening endeavors.
The private sector stands to make an enormous difference in this endeavor. From a health systems perspective, the private sector can leverage PSRT’s framework to extend beyond global health security and further strengthen the main components of health systems: equipment and technology, sufficient numbers of adequately trained people, and strong systems in place to advance care delivery. The private sector can leverage a wide range of capabilities – from innovative data collection technologies to supply chain management practices to vast geographic presence and personnel – to support countries in need to build their health systems.
The good news is that it is possible to take something as complex as the global surgical crisis and drive meaningful progress. But to build a better ecosystem for safe surgery, we must take collaborative, tangible, and measurable action within the private sector to build this capacity. This collective engagement to address the dire need for access to safe surgery on a global scale will, most certainly, save the lives of millions of individuals and strengthen their communities and local health systems.
With such involvement and commitment, each of our companies will changes the lives of those who need it most, will offer our employees the chance to brag with pride about the companies for whom they work, and will elevate our brands as good and committed global citizens. I encourage my colleagues leading in this space to ask questions, learn more about the need for global safe surgical capacity and engage meaningfully in initiatives that build capacity to save lives with safe surgery.
[i] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60160-X/fulltext