Global surgery in the firing line? The case for social surgery.

A case against global health, given resource concentration in powerful and wealthy countries, raises concerns within the field of global surgery.1Horton R Offline: The case for global health.Lancet. 2023; 4011639Google Scholar Global surgery aims to address disparities in surgical care and outcomes between high-income countries and low-income and middle-income countries (LMICs).2Dare AJ Grimes CE Gillies R et al.Global surgery: defining an emerging global health field.Lancet. 2014; 384: 2245-2247Summary Full Text Full Text PDF PubMed Scopus (101) Google Scholar International surgical missions in LMICs are commendable, but largely fail to address domestic health disparities. Building a case for social surgery pertains to mobilising surgeons and exploring resources, practices, and investment, ensuring universal access to surgery in both high-income countries and LMICs.3Tsagkaris C Papadakis M MatiashovaIs L Is it about time to develop social surgery?.Am J Surg. 2022; 225: 151-153Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar, 4Adeyi O Global health in practice: investing amidst pandemics, denial of evidence, and neo-dependency.https://ideas.repec.org//b/wsi/wsbook/12520.htmlDate: June, 2022Date accessed: May 27, 2023Google Scholar Establishing social surgery necessitates interdisciplinary collaboration; homelessness, unemployment, and social isolation should be examined with the same diligence as pain scales and molecular markers. Sharing the generated knowledge with scientists and the public can create a societal shift, incentivising decision makers to improve insurance coverage and social assistance for non-privileged individuals.5McKee M Field S Vella S Legido-Quigley H Kazatchkine M The EU has a global health strategy: the challenge will be in the implementation.Lancet. 2023; (published online Feb 16.)https://doi.org/10.1016/S0140-6736(23)00328-8Summary Full Text Full Text PDF Scopus (1) Google Scholar The experience gained from global surgery initiatives over the past four decades holds great potential to identify barriers to surgical care and to drive change in high-income countries where resources are already readily available. By promoting equity within their own countries, surgeons can earn the trust of stakeholders and individuals in LMICs. Patients in Africa, for example, would be more willing to entrust their lives to foreign surgeons if they know these same surgeons are breaking down access barriers in high-income countries too. Ensuring equitable, timely, and affordable access to surgery, regardless of a patient's ethnicity or socioeconomic background, is a crucial step towards achieving health for all and universal health coverage. We declare no competing interests. Offline: The case for global healthGlobal health has become fashionably unfashionable. The case against global health is strong. Global health is the invention of a largely white and wealthy elite residing in high-income, English-language speaking countries. The discipline claims to be concerned about the health of people living in low-income and middle-income settings. But the resources—human, infrastructural, and financial—underpinning global health are mostly concentrated in those countries already replete with power and money. Full-Text PDF