World Innovation Summit for Health provides a global perspective on surgery

Daw Aung San Suu Kyi - Keynote

Ms. Aung San Suu Kyi

John Dineen - Keynote

Mr. Dineen

Road Traffic Injury Panel Discussion

The road traffic injury panel discussion. From left: Professor Hyder, Dr. Al-Thani, Dr. Ghaffar, Ms. Larson, Ms. DiPietro, and Dr. Saoud.

Simon Steven's Keynote

Mr. Stevens

HH Sheikha Moza attends WISH gala dinner

From left: Mayor of London Boris Johnson, Princess Lalla Salma of Morocco, Sheikha Moza, and the Duke of York.


The inaugural World Innovation Summit for Health (WISH), which took place December 10–11, 2013, in Doha, Qatar, proved to be a galvanizing experience for the global health and global surgery communities.

More than 1,000 international delegates from 67 nations convened for the WISH program, protected from the fierce desert sun by the imposing silhouette of an 800-foot steel sidra tree at the Qatar National Conference Centre, Doha. The summit brought together key health care visionaries, including members of royal households, political leaders, and health and finance ministers. Prof. Lord Ara W. Darzi, MD, MB, ChB, FACS, director of the Institute of Global Health Innovation at the Imperial College London, U.K., and co-author of this article, organized the event, and Her Highness Sheikha Moza bint Nasser, chair of Qatar Foundation, was the host.

Joining them were world authorities from clinical practice, academia, and industry. The shared goal of this group was to examine and debate the key policy challenges facing organized health care systems today and to identify practices, products, services, and business model innovations with the potential to elicit meaningful and universal health care transformation across the world. WISH’s leadership made headway in charging these communities to take a shared and proactive role in tackling some of the most pressing health care challenges experienced around the world today.

Global health care crisis

The global burden of surgical need cannot be overstated. Surgical issues ranging from trauma and road traffic injuries to the systems within which surgical services are delivered, along with the prudent use of antimicrobial drugs, have an enormous impact on the population, health, and economies of low-, middle- and high-income countries. Sadly, the inequities in access to surgical services and the disparities in quality of care have a disproportionate effect on the world’s poorest citizens.1,2

Across the globe, high-impact examples of innovative policies, technologies, business models, and services are available that could drive transformative health care system improvements and benefit patients if appropriately diffused and adopted. WISH sought to celebrate and focus the international community on the successes and future potential of some of the individuals and organizations leading these efforts.

Speakers and sessions

An impressive and articulate group of keynote speakers offered their expertise and evidence regarding the major issues in global health care ranging from the human and workforce resources required to support health care systems to the need to adapt existing innovations and technologies in response to the financial crisis. These lecturers included: Nobel Peace Prize recipient Daw Aung San Suu Kyi, chair of the National League for Democracy, Myanmar, Burma; Simon Stevens, president of the Global Health Division and executive vice-president, UnitedHealth Group, based in Minneapolis-St. Paul, MN; and John Dineen, president and chief executive officer, General Electric Healthcare, based in Fairfield, CT.

Panel discussions drew together leading authorities for lively and facilitated discussions across eight key themes: big data and health, accountable care, end-of-life and palliative care, mental health, antimicrobial resistance, patient engagement, obesity, and road traffic injuries. For each of these globally pertinent topics, a forum of high-profile leaders assembled up to a year in advance in an effort to draw expert consensus, scan the horizon for innovations, and develop high-impact and universally applicable recommendations.

Identifying and promoting innovations that have been proven to work and have a positive impact across geographies and the range of world economies was a distinctive feature and aim of the summit. Through the reports and keynote presentations, emphasis was placed on the impact of low-cost and disruptive innovations that have been born of necessity in low-resource settings or adapted from existing technologies or practices in high-income settings, which have the potential for application and utility to a universal market.

Through these solutions and a strong list of attendees, surgery was well-represented at WISH. Four American College of Surgeons (ACS) Fellows attended, including Prof. Lord Darzi; Andrew Kingsnorth, MB, BS, FACS, a general surgeon in Plymouth, U.K.; John Maa, MD, FACS, President of the Northern California Chapter of the ACS and chair, University of California office of the president tobacco-related disease research program scientific advisory committee; and ACS President Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), The Henry N. Harkins Professor and Chair, department of surgery, University of Washington, Seattle, and co-author of this article.

Operation Hernia, cofounded by Dr. Kingsnorth and Chris Oppong, MD, was recognized by the delegates at WISH for having significant global impact. Operation Hernia promotes professional and educational opportunities for hernia repairs in rural settings across Africa, South America, Eastern Europe, and Asia. The organization received significant attention in 2013 for using readily available mosquito nets as a frugal alternative to traditional mesh repair.3 Another high-impact innovation was the Solvatten solar-powered water purifier donated by a charitable organization in Sweden. Solvatten uses novel and low-cost technology to provide a sustainable fresh water supply for those in low-resource settings. Operation Hernia and Solvatten are just two of the 15 services, devices, and business model innovations showcased at WISH, due to their proven success and future global potential.

Traffic-related trauma

Surgery was identified as crucial subject matter across several of the panel discussions and policy report topics at WISH. On day two of the summit, a plenary session chaired by Prof. Adnan Hyder, MD, PhD, of Johns Hopkins University, Baltimore, MD, convened five leading experts, including Gayle DiPietro, global manager, Bloomberg Philanthropies Global Road Safety Program at the Global Road Safety Partnership; Abdul Ghaffar, MD, PhD, executive director, Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland; Kelly Larson, programme director, Bloomberg Philanthropies, New York, NY; Mohammed Fathy Saoud, PhD, senior advisor to the chairperson, Qatar Foundation; and Hassan Al-Thani, MB, ChB, FRCS, head of trauma, vascular, and general surgery, Hamad General Hospital, Doha, Qatar. These panelists debated key challenges and recommendations on road traffic injuries.4 Discussions at WISH highlighted the rising human and economic burden of road traffic injuries, which disproportionately affect low- and middle-income nations, as a significant global challenge and one requiring an international and multi-sectorial response.5

Experts at WISH sought to challenge the global health community to treat road traffic injuries as it would any other public health crisis. It was proposed that to stratify defined etiological factors—including youth, gender and social status—it would be possible to develop a targeted framework for action. The panel discussion looked to emphasize the key baseline policies, including regulating the use of seatbelts, driving under the influence, and the use of helmets for motorcycles. The report also looked more broadly to the health care stakeholders that play a role in the management of affected patients. Surgeons, trauma care specialists, and prehospital health care providers were identified as crucial figures.

Areas highlighted for greater focus included the championing of best surgical practices and the promotion and diffusion of high-impact innovations, such as the use of tranexamic acid as a low-cost and effective treatment found to significantly reduce fatal bleeding associated with trauma.6 The panelists also advocated for surgeons to play a role in designing and promoting integrated trauma care systems, such as the successful model used in London, U.K.7

Additionally, repeated calls were issued for improved access to high-quality and appropriate training and education for surgeons, first responders, and prehospital care workers. Specifically, in rural and low-income settings more energy and resources are required to promote task-shifting and competence-building among community health care practitioners and the lay public. The purpose of this effort is to equip isolated and impoverished communities with the basic but essential skills for managing victims of trauma and road traffic injuries. The Lancet Commission on Global Surgery will further explore this issue in its report to be published later this year.8

Stewardship

Another panel session focused on antimicrobial resistance and accountability in health care. Conserving the limited numbers of antimicrobial drugs available, raising the awareness of drug resistance to both patients and practitioner colleagues, and promoting sanitation and infection prevention are all simple steps that WISH has determined are vital to combating the growing global threat of antibiotic resistance.9

The Accountable Care Forum focused on identifying means of achieving value and high-quality care within health systems. It challenged surgeons and health care providers to champion transparency of data and to develop and maintain robust outcome frameworks across surgical practice and patient pathways to support value-based reconfiguration of services.10

From antimicrobial resistance and accountable care to road traffic injuries and the summit’s spotlight on innovation, the 2013 WISH meeting highlighted the important role of surgery in many of the pressing global health care challenges faced today. The summit promises to become a meaningful and high-profile component of the global health initiative and will serve as a platform for surgeons and other health care providers to identify, discuss, and debate innovative solutions and recommendations. With a surgeon at the helm, the organization will undoubtedly remain an opportunity for the surgical community to further establish itself as a key stakeholder in global health care.


References

  1. Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2095-2128.
  2. Mokdad AH, Jaber S, Abdel Aziz MI, et al. The state of health in the Arab world, 1990-2010: An analysis of the burden of diseases, injuries and risk factors. The Lancet. 2014;383(9914)309-320.
  3. Sanders DL, Kingsnorth AN, Moate R, Steer JA. An in vitro study assessing the infection risk of low-cost polyethylene mosquito net compared with commercial hernia prosthetics. J Surg Res. 2013;183(2):e31-37.
  4. Puvanachandra P, Allen AK, Hyder AA. Road traffic injury and trauma care: Innovations for policy (Road Trip). Report of the Road Traffic Injuries Working Group. Available at: http://www.wish-qatar.org/app/media/388. Accessed February 15, 2014.
  5. United Nations. General Assembly. Improving global road safety. Note by the Secretary-General. September 6, 2013. Available at: http://www.un.org/ga/search/view_doc.asp?symbol=A/68/368. Accessed February 15, 2014.
  6. CRASH-2 collaborators, Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: An exploratory analysis of the CRASH-2 randomised control trial. Lancet. 2011;377(9771):1096-1101.
  7. London Health Programmes. Services. Major trauma. Available at: http://www.londonprogrammes.nhs.uk/services/major-trauma/. Accessed February 15, 2014.
  8. Meara JG, Hagander L, Leather AJM. Surgery and global health: A Lancet Commission. Available at: http://www.globalsurgery.info/wp-content/uploads/2013/11/GSCommission-Comment.pdf. Accessed February 15, 2014.
  9. Verde ER, Davies S. Antimicrobial resistance: In search of a collaborative. Report of the Antimicrobial Resistance Working Group 2013. Available at: http://www.wish-qatar.org/app/media/385. Accessed February 15, 2014.
  10. Cohen S, Shuttleworth B, Thoumi A, et al. Accountable care: Focusing accountability on the outcomes that matter. Report of the Accountable Care Working Group. Available at: http://www.wish-qatar.org/app/media/384. Accessed February 15, 2014.

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