By Asha Varghese, Director of Global Health, GE Foundation

Global surgery has been a neglected global health priority for decades, so much so that over five billion people globally lack access to surgery. Simple operations, often taken for granted in the developed world, are largely inaccessible or unsafe for people living in low and middle- income countries. Ensuring that safe surgical care is within reach of everyone, everywhere, requires collaborative action across the public and private sectors.

From Tanzania to Pakistan, governments are committed to improving access to surgery by developing and implementing National Surgical, Obstetric and Anaesthesia Plans. Momentum is building for surgery with local NGOs developing programs to accelerate workforce capacity, and local start-ups seeking to solve infrastructure challenges.

The private sector has a huge role to play in catalyzing progress on surgery and strengthening surgical systems. Beyond funding, private sector actors can and are adapting core business capabilities – whether strategic planning, supply chain management practices or innovative data collection technologies – to address the issue. Through a growing number of private-public partnerships, we have the ability to save millions of lives, prevent many more disabilities, and strengthen the entire healthcare system through surgical care.

In 2015, GE Foundation launched Safe Surgery 2020, a partnership designed to help stimulate and build better surgical capacity in low- and middle-income countries. From the outset, the partnership model was differentiated by its ability to leverage diverse capabilities across sectors to respond to needs on the ground, allowing the partnership to scale across countries with distinct health landscapes. Importantly, we are partnering with governments who are directing their Safe Surgery 2020’s country strategies, to ensure local ownership and that activities are aligned with their existing priorities and a continuous knowledge transfer.

Safe Surgery 2020 first launched in Ethiopia in 2016, expanding to Tanzania in 2017 and Cambodia and Laos this year. Through a national surgical planning program, we are supporting governments in prioritizing surgery, identifying gaps in surgical care and mobilizing necessary resources. We developed, tested, and refined a training program package which is transforming district hospitals by empowering surgical teams to problem solve together, hone clinical skills and adopt best practices like the safe surgery checklist.

In Tanzania, technology has been further integrated into our portfolio to facilitate remote mentoring and training.  This is enabling us to increase the frequency of trainings, while reducing both time and financial costs associated with mentors and trainers travelling to primary facilities.  Additionally we have launched a simulation-training app through which surgical teams are provided with step-by-step training https://www.safesurgery2020.org/updates/digital-surgery-stimulation-training-tanzania

As private-public partnerships increasingly tackle larger and more complex issues, such as surgery, we hope sharing our learnings from Safe Surgery 2020 will support others to maximize the breadth of capabilities within partnerships:

• Become comfortable with iteration and expect the final interventions to look different to the original design. As we strived to maximise the partnership’s impact, we had to be responsive to feedback and local needs. We’ve shifted delivery modes, embraced new approaches, and even changed our implementation model as we’ve entered new regions.
• Develop trust between partners by prioritizing internal communication. We constantly iterated on the modes of internal communication, adapting to the changing needs of the partnership.
• Clarity on roles and responsibilities is even more important for partnerships with diverse partners. We found that having distinct responsibilities for each partner boosted collaboration, rather than disincentivising it.