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Building Resilient Health Systems

Global Surgery

Surgeons operatingThe landmark initial report from the Lancet Commission on Global Surgery - Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development - describes the role of surgical and anaesthesia care in improving the health of individuals and the economic productivity of countries.

The report featured 5 key messages:

  1. 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed
  2. 143 million additional surgical procedures are needed each year to save lives and prevent disability
  3. 33 million individuals face catastrophic health expenditure due to payment for surgery and anaesthesia each year
  4. Investment in surgical and anaesthesia services is affordable, saves lives, and promotes economic growth
  5. Surgery is an indivisible, indispensable part of health care

Andy Leather, Director of the King’s Centre for Global Health was appointed one of the three co-chairs of the Lancet Commission on Global Surgery, which launched in 2014 and published Global Surgery 2030 a year later.

President of the World Bank, Dr Jim Yong Kim, called for a ‘shared vision and strategy for global equity in essential surgical care,’ at the first meeting of the Commission in January 2014, stating ‘surgery is an indivisible, indispensable part of health care.’

King’s is working to drive this vision and strategy forward, by ensuring global surgery is an integrated component in building and strengthening healthcare systems in countries where there is urgent need. The Centre for Global Health under King’s Health Partners works in partnership with teams in Sierra Leone, Somaliland, Zambia and Democratic Republic of Congo (DRC), helping to increase access to surgical and anaesthesia care for people in these areas.

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Primary research into global surgery at King’s is broad and includes global and national surgical policy, advocacy, cost effectiveness of surgical care, economics consequences of surgical disease, catastrophic health expenditure from surgery, funding for surgery, demographics of patients and trauma care in low and middle income countries.

The global surgery group at King’s is involved in supporting the Ministry of Health and Sanitation in Sierra Leone to develop national surgical and anaesthetic policy and implement the findings of both the Lancet Commission on Global Surgery and the World Health Resolution 68.15 on ‘Strengthening Emergency and Essential Surgical Care and Anaesthesia as a Component of Universal Health Coverage.’

This support is provided through the King’s Sierra Leone Partnership and has involved facilitating a Ministry led national surgical and anaesthetic stakeholder meeting on 6 May 2016 (see photo) with the WHO.

We continue to provide technical support to the national surgical and anaesthetic committee and we are also supporting the development of postgraduate training for surgery through our team based at Connaught Hospital, the national referral hospital in Freetown. Our partnership work at Connaught is led by Mr Niyi Ade-Ajayi.

We are also supporting surgical and anaesthesia care through the health partnership programmes in Somaliland and Democratic Republic of Congo, under the leadership of Ms Naomi Wright in Somaliland and Ms Liz Tissingh in DRC.

In Somaliland we support undergraduate teaching in surgery and provide external examiners for the University of Hargeisa and Amoud University in Boroma. Our teaching is both face to face as well as through the Medicine Africa Platform.

In the DRC, our partnership is with the Kongo Central District Ministry of Health and key hospitals in the district, and focused on capacity building for trauma care. This includes training for trauma care, development of a trauma registry and policy work with the Ministry.

First national surgical and anaesthetic stakeholder meeting in Freetown, Sierra Leone May 2016The first national surgical and anaesthetic stakeholder meeting in Freetown, Sierra Leone on 6 May 2016

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Andy Leather  Mr Andrew Leather
Director, King's Centre for Global Health 
Paula Baraitser  Dr Paula Baraitser
Programme Lead, Global Health MSc 
  Mr Niyi Ade-Ajayi
Partnership Lead, Sierra Leone
  Miss Naomi Wright

Partnership Lead, Somaliland


Ms Liz Tissingh, Partnership Lead
Democratic Republic of Congo


Page break lineMaking an impact

Lancet Commission on Global SurgeryGlobal Surgery 2030: Evidence and Solutions for Achieving Health, Welfare and Economic Development
Developed by a multidisciplinary team of 25 commissioners and collaborators from over 110 nations, the report presents findings on the state of surgical care in low-income and middle-income countries (LMICs), as well as a framework of recommendations, indicators and targets needed to achieve the Commission’s vision of universal access to safe, affordable surgical and anaesthesia care when needed. The paper was published in the Lancet in 2015.

These findings create a powerful argument for:

  • Governments in LMICs to strengthen surgical services and the national health systems that provide them
  • Global health and development organisations to include indicators of surgical care within existing health goals and monitoring systems
  • Funding agencies to invest in surgical care as a tool for poverty alleviation and general welfare gains
  • International partners to support local leaders in their efforts to provide equitable surgical care
  • The general public to lobby for access to surgical services for all.

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  • Global Health (with Global Surgery) MSc
    Surgical modules include ‘Current concepts in Global Surgery’ and ‘District Hospital Surgical Practice in low and middle income countries’.
  • Surgical teaching to undergraduate students in Somaliland
  • External examiners for the University of Hargeisa and Amoud University in Boroma, Somaliliand
  • Online teaching through the Medicine Africa Platform
  • Training for trauma care in partnership with Kongo Central District Ministry of Health, DRC
  • Andy Leather is patron of the Global Anaesthesia, Surgery & Obstetric Collaboration (GASOC) training network, a national society of doctors in training. The Centre for Global Health hosts monthly GASOC journal clubs chaired by Ms Kat Ford, a paediatric surgical trainee.

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Find out more about what King's is doing in the field of global surgery


05 July 2017


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