Advocating for Surgical Investment with the G4 Alliance
How can we build stronger health systems to better prevent, prepare for, and respond to the next pandemic? This is the question that leading world financial institutions want to address through the Pandemic Fund established within the World Bank. The Fund is especially mandated to address these challenges in low and middle-income countries (LMICs). But, as Peruvian pediatric surgeon Dr. Weislawa de Pawlikowski states, “We don’t have time to prepare for a future pandemic or emergency. The emergency is already here.”
In an effort to contribute to and guide the discussion of the Pandemic Fund’s role and investments, Solidarity Bridge and six other member organizations of the G4 Alliance for Surgical, Obstetric, Trauma and Anesthesia Care organized a panel discussion to run alongside World Bank and IMF meetings held in April in Washington, DC.
The event, titled Building Health System Resilience: Lessons from the COVID-19 Pandemic, presented viewpoints from government and academic institutions from Ethiopia, Rwanda, Colombia, Peru, and Nigeria. Each speaker presented compelling data and stories from the COVID-19 response in their countries and shared how the pandemic brought additional stress to healthcare systems that were already poorly funded and under-resourced. They also shared stories of a resilient workforce and the many lessons learned as they persevered through this challenging time.
In many aspects of society, it may feel like the COVID-19 pandemic is over, yet we are still living with devastating human, economic, and social costs. Surgical patients in particular still face immense impacts. In Peru, for example, hospitals stopped performing elective surgeries during the height of the pandemic. This created a backlog of over 94,500 patients, many of whom are still waiting to be treated. Dr. De Pawlikowski, from the Ministry of Health of Peru, stated that 84% of these unmet needs are concentrated in general surgery, gynecology, cardiovascular, ophthalmology, and orthopedic surgeries. Compounding this problem is the fact that less than 50% of hospitals are equipped to address this backlog. Our allied medical partners in Bolivia and Paraguay report similar challenges to catching up with the backlog of surgical patients.
Panel speakers at the D.C. event argued for the importance of investing in comprehensive surgical and anesthesia care as fundamental to future pandemic preparedness. Evidence shows that countries that mounted the most effective response to COVID-19 were those in which the whole healthcare system was strong and where surgical, anesthesia, emergency, and critical care were integrated, ensuring continuity of care amidst the pandemic. When surgeries were paused, strong surgical facilities and workforces could effectively pivot to help address the immediate COVID emergency. But in many LMICs, investments in surgical capacity lag far behind higher income countries, making it difficult for hospitals to build resilient systems.
World Bank representative Dr. Mickey Chopra (Global Solutions Lead for Service Delivery in the Health, Nutrition and Population global practice of the World Bank) was particularly important to have on the discussion panel. Dr. Chopra listened with interest to the arguments made for surgical investment and explained how LMICs may apply for funding through their Health Ministries. This is an opportunity for organization members of the G4 Alliance to advocate in their countries for the importance of strengthening the whole of the healthcare system, particularly through investments in surgery.
Solidarity Bridge was represented at the Pandemic Fund panel event by our Board member Dr. Richard Moser and Senior Director of Medical Programs Maria Eugenia Brockmann. Richard and Maria Eugenia also attended several additional activities that took advantage of the confluence of the global surgery community in the U.S. capital. They met with Maggie Angel, legislative assistant to Illinois Senator Dick Durbin, to encourage the powerful Senator to vote in favor of the proposed allocation of $10 million for the US Agency for International Development (USAID) to support surgical systems in LMICs. And they were joined by Solidarity Bridge Medical Director Dr. Gay Garrett to participate in a conference titled Broadening the Tent through Innovation and Entrepreneurship, organized by the Program in Global Surgery and Social Change at Harvard Medical School. This conference was part of the annual meeting of the Consortium of Universities on Global Health organized in conjunction with the World Health Summit Regional Meeting and the AAHCI Global Innovation Forum. In this event, our three Solidarity Bridge representatives engaged in discussions and brainstorming exercises with organizations, policymakers, and financial development experts from around the globe on the role of innovation and entrepreneurship in projects that promote access to safe, timely, and accessible surgical care in LMICs.
(l-r) Dr. Gay Garret, SB Medical Director; Maria Eugenia Brockmann, SB Senior Director of Programs; Dr. Richard Moser, SB Board Member and NNI President
Dr. Moser joins other global surgery experts in a brainstorming exercise.
It was a busy week in the US capital. While it is not the primary focus of our day-to-day work, we recognize that advocacy is an important tool to promote access to safe, timely, and affordable surgeries for the patients we aim to serve in South America as well as our brothers and sisters in need throughout the world. Opportunities like this to convene with like-minded colleagues from across the globe are also an important reminder that we are not alone in this mission.