Scalable policy adoption and sustainable implementation of surgical care in the Americas

Nikathan Kumar¹, Gabriella Y Hyman¹, Ayla Gerk¹, Taylor Wurdeman¹, Tarsicio Uribe-Leitz¹, Scott Corlew¹, Kee B Park¹, John G Meara¹, Robert Riviello¹, Emmanuel M Makasa², Jimmy Kolker³, Joanne Manrique⁴, Rubén E Ayala⁵, Geoffrey C Ibbotson⁶, Alex Mejia⁷, Luiz Fernando Falcão⁸, Maria Jose Garcia Fuentes⁹, Mauricio Montalvo-Samaniego¹⁰, Ivonne A Baki¹¹, Ernesto Bascolo¹², Alfredo Borrero Vega⁹

Affiliations

¹ Program in Global Surgery and Social Change Harvard Medical School Boston, MA USA Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
² Department of Surgery University of the Witwatersrand Johannesburg South Africa Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
³ U.S. Department of Health and Human Services Washington, D.C. USA (retired) U.S. Department of Health and Human Services, Washington, D.C., USA (retired).
⁴ Women's Health and Economic Empowerment Network Washington, D.C. USA Women's Health and Economic Empowerment Network, Washington, D.C., USA.
⁵ Department of Health Policy and Advocacy Operation Smile Virginia Beach, VA USA Department of Health Policy and Advocacy, Operation Smile, Virginia Beach, VA, USA.
⁶ The Global Surgery Foundation Geneva Switzerland The Global Surgery Foundation, Geneva, Switzerland.
⁷ United Nations Institute for Training and Research (UNITAR) Geneva Switzerland United Nations Institute for Training and Research (UNITAR), Geneva, Switzerland.
⁸ Department of Anesthesia, Pain and Critical Care Medicine Federal University of Sao Paulo Sao Paulo Brazil Department of Anesthesia, Pain and Critical Care Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.
⁹ Corporación Latinoamericana para la Salud Quito, Pichincha Ecuador Corporación Latinoamericana para la Salud, Quito, Pichincha, Ecuador.
¹⁰ Permanent Representative of Ecuador to the Organization of American States Washington, D.C. USA Permanent Representative of Ecuador to the Organization of American States, Washington, D.C., USA.
¹¹ Embassy of Ecuador in France Paris France Embassy of Ecuador in France, Paris, France.
¹² Primary Health Care and Integrated Service Delivery Pan American Health Organization Washington, D.C. USA Primary Health Care and Integrated Service Delivery, Pan American Health Organization, Washington, D.C., USA.

PMID: 39633825
PMCID: PMC11616459
DOI: 10.26633/RPSP.2024.132

Scalable policy adoption and sustainable implementation of surgical care in the Americas

Nikathan Kumar et al. Rev Panam Salud Publica. 2024.

. 2024 Dec 4:48:e132.

doi: 10.26633/RPSP.2024.132. eCollection 2024.

Authors

Affiliations

¹ Program in Global Surgery and Social Change Harvard Medical School Boston, MA USA Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
² Department of Surgery University of the Witwatersrand Johannesburg South Africa Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
³ U.S. Department of Health and Human Services Washington, D.C. USA (retired) U.S. Department of Health and Human Services, Washington, D.C., USA (retired).
⁴ Women's Health and Economic Empowerment Network Washington, D.C. USA Women's Health and Economic Empowerment Network, Washington, D.C., USA.
⁵ Department of Health Policy and Advocacy Operation Smile Virginia Beach, VA USA Department of Health Policy and Advocacy, Operation Smile, Virginia Beach, VA, USA.
⁶ The Global Surgery Foundation Geneva Switzerland The Global Surgery Foundation, Geneva, Switzerland.
⁷ United Nations Institute for Training and Research (UNITAR) Geneva Switzerland United Nations Institute for Training and Research (UNITAR), Geneva, Switzerland.
⁸ Department of Anesthesia, Pain and Critical Care Medicine Federal University of Sao Paulo Sao Paulo Brazil Department of Anesthesia, Pain and Critical Care Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.
⁹ Corporación Latinoamericana para la Salud Quito, Pichincha Ecuador Corporación Latinoamericana para la Salud, Quito, Pichincha, Ecuador.
¹⁰ Permanent Representative of Ecuador to the Organization of American States Washington, D.C. USA Permanent Representative of Ecuador to the Organization of American States, Washington, D.C., USA.
¹¹ Embassy of Ecuador in France Paris France Embassy of Ecuador in France, Paris, France.
¹² Primary Health Care and Integrated Service Delivery Pan American Health Organization Washington, D.C. USA Primary Health Care and Integrated Service Delivery, Pan American Health Organization, Washington, D.C., USA.

PMID: 39633825
PMCID: PMC11616459
DOI: 10.26633/RPSP.2024.132

Abstract
in English, Spanish, Portuguese

On September 29, 2023, the Republic of Ecuador convened a meeting to address surgical system strengthening and urge political leaders to invest in surgical infrastructure. The meeting included experts in health diplomacy, innovative financing, implementation strategy and national surgical plans. The event occurred in parallel with the Sixtieth Directing Council of the Pan American Health Organization, Seventy-fifth session of the World Health Organization Regional Committee for the Americas. The meeting centered around four major areas: (i) building surgical capacity as a means to develop universal health care and emergency preparedness; (ii) developing policies and strategies for strengthening surgical systems; (iii) developing models for financing, sustaining, and improving surgical systems in low- and middle-income countries; and (iv) evaluating implementation strategies for funding these endeavors. National surgical plans represent a critical opportunity to build resilient health care systems by establishing comprehensive and sustainable policies. This article highlights the key messages from the event, which focused on Latin America, to inform the broader global health community.

El 29 de septiembre del 2023, República de Ecuador convocó una reunión para abordar el fortalecimiento del sistema quirúrgico e instar a las autoridades políticas a realizar inversiones en infraestructura quirúrgica. En la reunión participaron expertos en diplomacia de la salud, financiamiento innovador, estrategias de implementación y planes quirúrgicos nacionales. El evento se celebró en paralelo con el 60.^o Consejo Directivo de la Organización Panamericana de la Salud y la 75.^a Sesión del Comité Regional de la Organización Mundial de la Salud para las Américas La reunión se centró en cuatro áreas principales: i) el aumento de la capacidad quirúrgica como medio para avanzar en la atención universal de salud y la preparación para emergencias; ii) la formulación de políticas y estrategias para fortalecer los sistemas quirúrgicos; iii) la elaboración de modelos para financiar, sostener y mejorar los sistemas quirúrgicos en países de ingresos bajos y medianos; y iv) la evaluación de las estrategias de implementación para el financiamiento de estas iniciativas. Los planes quirúrgicos nacionales brindan una oportunidad crucial para la creación de sistemas de atención de salud resilientes mediante el establecimiento de políticas integrales y sostenibles. En este artículo se resaltan los mensajes más destacados del evento, que estuvo centrado en América Latina, a fin de proporcionar información a la comunidad de la salud más amplia a nivel mundial.

Em 29 de setembro de 2023, a República do Equador convocou uma reunião para tratar do fortalecimento do sistema de atenção cirúrgica e exortar as lideranças políticas a investir em infraestrutura. Participaram da reunião especialistas em diplomacia da saúde, financiamento inovador, estratégia de implementação e planos nacionais de atenção cirúrgica. O evento ocorreu em paralelo ao 60º Conselho Diretor da Organização Pan-Americana da Saúde, 75^a Sessão do Comitê Regional da Organização Mundial da Saúde para as Américas. A reunião abordou quatro áreas centrais: (i) capacitação cirúrgica como forma de fazer avançar a atenção universal à saúde e a preparação para emergências; (ii) elaboração de políticas e estratégias para fortalecer os sistemas de atenção cirúrgica; (iii) criação de modelos para financiar, sustentar e melhorar os sistemas de atenção cirúrgica nos países de baixa e média renda; e (iv) avaliação de estratégias de implementação para financiar esses esforços. Ao estabelecer políticas integrais e sustentáveis, os planos nacionais de atenção cirúrgica representam uma oportunidade fundamental para criar sistemas de saúde resilientes. Este artigo destaca as principais mensagens desse evento voltado à América Latina, a fim de informar a comunidade mundial de saúde.

Keywords: Latin America; Pan American Health Organization; Surgery; health system resilience; national health programs.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest. ABV was the acting vice president of Ecuador and MJGF was employed by the office of the vice president at the time of this meeting. They have since founded and are on the executive board of the nonprofit organization Corporación Latinoamericana para la Salud. IAB and MMS are both ambassadors of Ecuador. REA is the chief of policy and advocacy for Operation Smile. GCI is the executive director of The Global Surgery Foundation. AM is the division director at UNITAR. LFF is the director of memberships for the World Federation of Societies of Anaesthesiologists, the chief medical officer at Anextesia, and the director of international affairs at the Brazilian Society of Anesthesiology. EB is the unit chief of Primary Health Care and Integrated Service Delivery at PAHO. JK serves part-time as senior adviser to the Coordinator for Global COVID-19 Response and Health Security at the U.S. Department of State. JM is the president of the Center for Global Health and Development. NK, GYH, AG, TW, TUL, SC, KBP, JGM, RR, and EM do not have any disclosures to declare.

References

1. World Health Organization . UN High-level Meetings on Universal Health Coverage [Internet] Geneva: World Health Organization; 2024. [cited 2024 Apr 12]. Available from: https://www.who.int/activities/preparing-for-the-un-high-level-meeting-2....
2. World Health Organization. UN High-level Meetings on Universal Health Coverage [Internet]. Geneva: World Health Organization; 2024 [cited 2024 Apr 12]. Available from: https://www.who.int/activities/preparing-for-the-un-high-level-meeting-2...
1. World Health Assembly . In: Sixty-eighth World Health Assembly, 26 May 2015. Geneva: World Health Organization; 2015. Resolution WHA68.15. Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage.https://iris.who.int/handle/10665/253244 - PubMed
2. World Health Assembly. Resolution WHA68.15. Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage. In: Sixty-eighth World Health Assembly, 26 May 2015. Geneva: World Health Organization; 2015. https://iris.who.int/handle/10665/253244 - PubMed
1. Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN. Volume 1: essential surgery. 3rd. Washington (DC): World Bank; 2015. Disease control priorities.
2. Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease control priorities. 3rd ed. Volume 1: essential surgery. Washington (DC): World Bank; 2015. - PubMed
1. GBD 2019 Diseases and Injuries Collaborators . Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Vol. 396. Lancet; 2020. pp. 1204–22. - PMC - PubMed
2. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–22. - PMC - PubMed
1. Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health. 2023;19:62. - PMC - PubMed
2. Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health. 2023;19:62. - PMC - PubMed

LinkOut - more resources

Full Text Sources
- PubMed Central

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Scalable policy adoption and sustainable implementation of surgical care in the Americas

Affiliations

Scalable policy adoption and sustainable implementation of surgical care in the Americas

Authors

Affiliations

Abstract
in English, Spanish, Portuguese

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources

Abstract in English, Spanish, Portuguese

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources

Abstract
in English, Spanish, Portuguese