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Global cardiac surgery: lessons learnt from the global neurosurgery movement
  1. Dominique Vervoort1,
  2. Kee B Park1,
  3. JaBaris D Swain2
  1. 1 Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Dominique Vervoort, Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts 02115-6019, USA; vervoortdominique{at}hotmail.com

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Introduction

Surgical care is increasingly considered as a crucial pillar of robust health systems. Five billion people worldwide lack access to safe surgical care, responsible for 16.9 million deaths every year and one-third of the global burden of disease.1 Contrary to previous belief, investing in surgical care is cost-effective on an individual and macroeconomic level, preventing a loss of 12.3 trillion dollars in economic growth by low-income and middle-income countries (LMICs) by 2030.1

In the past decade, the field of global surgery has gradually evolved, with its zenith paralleling the 2015 launch of the Lancet Commission on Global Surgery and the WHO Resolution WHA68.15. Since this release, several surgical subspecialties have gained important ground to create awareness surrounding the importance of their respective fields within the wider discussions. For example, the World Federation of Societies of Anaesthesiologists established a global platform for anaesthesiologists focused on capacity-building and promoting safety and quality of care, particularly in resource-constrained settings. Paediatric surgery has developed a global consensus group within the Global Initiative for Children’s Surgery, addressing its global disparities. Neurosurgery, once discarded as too complex for LMICs, has evolved to become a mainstay of global health discussions. Strategic efforts to heighten visibility and awareness about the need for expansion of neurosurgical services have led neurosurgery to become a major priority of the WHO’s Emergency and Essential Surgical Care Programme.

Cardiac surgery, however, can be considered the unborn child of global surgery, with limited unified efforts to address the >4.5 billion people without access to cardiac surgery.2 To illustrate, the third edition of the Disease Control Priorities, examining the global burden of disease and cost-effective interventions, does not include any cardiac intervention …

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