In reply: Clarifying surgery and anesthesia partnerships in response to global surgery and the World Health Organization
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CORRESPONDENCE
In reply: Clarifying surgery and anesthesia partnerships in response to global surgery and the World Health Organization Che´ L. Reddy, MBChB, MPH . Luke Caddell, MS . Adrian W. Gelb, MBChB, FRCPC . Desmond T. Jumbam, MSGH . Rolvix H. Patterson, BA . Lauri Romanzi, MD, MScPH . John G. Meara, MD, DMD, MBA
Received: 3 September 2019 / Revised: 3 September 2019 / Accepted: 3 September 2019 Ó Canadian Anesthesiologists’ Society 2019
To the Editor, We welcome the comments from Drs Walter Johnson and Emmanuel Makasa1 on our paper2,3 and thank them for their contributions, which serve to enrich and deepen the discourse in global surgery. They are correct in pointing out that the World Health Assembly Resolution 68.15 does not explicitly include the need to strengthen obstetrics or
C. L. Reddy, MBChB, MPH (&) D. T. Jumbam, MSGH J. G. Meara, MD, DMD, MBA Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA e-mail: [email protected] Department of Plastic and Oral Surgery, Boston Children’s Hospital, Boston, MA, USA L. Caddell, MS Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA Miller School of Medicine, University of Miami, Miami, FL, USA A. W. Gelb, MBChB, FRCPC Department of Anesthesia & Perioperative Care, University of California San Francisco, San Francisco, CA, USA World Federation of Societies of Anaesthesiologists, London, UK R. H. Patterson, BA Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA Tufts University School of Medicine, Boston, MA, USA L. Romanzi, MD, MScPH New York, NY, USA
emergency care and that there are 17 sustainable development goals (SDGs) designed to promote global peace and prosperity. Nevertheless, they raise four additional issues that we want to clarify. First, we suggested that efforts to strengthen global health systems through the provision of timely, safe, and affordable surgical care would help support the attainment of the triple billion goals. We did not intend to imply that this sentiment was expressed in the 13th General Progamme of Work (GPW13). Nevertheless, it was precisely this overlap in vision between the World Health Organization (WHO) and the global surgery movement to which we drew special attention—the GPW13 is an opportunity to work towards the common goals of strengthening global health systems and promoting sustainable development. This was the chief advocacy argument of our paper.2,4 Second, National Surgical, Obstetric, and Anesthesia Plans (NSOAPs) are one of numerous health system reform approaches to improve surgical care. We did not intend to imply that NSOAPs were the ‘‘only mechanism’’ to improve surgical systems or attain the SDGs. NSOAPs were highlighted as they provide a systematic, fully-costed, coordinated, and transparent policy approach1 to improve surgical care in the developing context.5 Third, we stated that the GPW13 aimed at advancing the WHO’s organizational vision (the attainment by all peoples of the highest poss
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