Ending Neglected Surgical Diseases (NSDs): Definitions, Strategies, and Goals for the Next Decade

Document Type: Perspective

Authors

1 The Global Alliance for Surgical, Obstetric, Trauma, and Anesthesia Care (G4 Alliance), Chicago, IL, USA

2 International Collaboration for Essential Surgery (ICES), Boca Raton, FL, USA

3 Department of Surgery, Florida Atlantic University (FAU), Boca Raton, FL, USA

4 Baylor College of Medicine Division of Plastic Surgery, Texas Children’s Hospital, Houston, TX, USA

5 Ministry of Health Kenya, Nairobi, Kenya

6 County Government of Meru County, Meru County, Kenya

7 Provincial Government of Odiongan, Odiongan, Philippines

8 Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland

9 Finders Keepers Technologies LLC, Boca Raton, FL, USA

10 University of Nairobi College of Health Sciences, Nairobi, Kenya

11 Mount Kenya University (MKU), Thika, Kenya

12 United Nations Population Fund (UNFPA), Nairobi, Kenya

13 Beyond Zero Secretariat, Kenya First Ladies’ Office, Nairobi, Kenya

14 United Nations Population Fund (UNFPA), Campaign to End Fistula, New York City, NY, USA

15 International Federation of Gynecology and Obstetrics (FIGO), Vancouver, BC, Canada

16 University of Oxford, Oxford, UK

17 Global Clubfoot Initiative (GCI), London, UK

18 Smile Train International, New York City, NY, USA

19 World Surgical Foundation (WSF) Philippines, Manila, Philippines

20 Orbis International, New York City, NY, USA

21 International Federation of Surgical Colleges (IFSC), London, UK

22 Child Family Health International Philippines, Manila, Philippines

23 Government of Trinidad and Tobago, Port of Spain, Trinidad and Tobago

24 Northwestern University Lurie Children’s Hospital, Chicago, IL, USA

25 Mobile Surgery International, Oaxaca, Mexico

26 University of Washington Harborview Injury Prevention and Research Center, Seattle, WA, USA

27 College of Surgeons of East, Central, and Southern Africa (COSECSA), Arusha, Tanzania

Abstract

While there has been overall progress in addressing the lack of access to surgical care worldwide, untreated surgical conditions in developing countries remain an underprioritized issue. Significant backlogs of advanced surgical disease called neglected surgical diseases (NSDs) result from massive disparities in access to quality surgical care. We aim to discuss a framework for a public health rights-based initiative designed to prevent and eliminate the backlog of NSDs in developing countries. We defined NSDs and set forth six criteria that focused on the applicability and practicality of implementing a program designed to eradicate the backlog of six target NSDs from the list of 44 Disease Control Priorities 3rd edition (DCP3) surgical interventions. The human rights-based approach (HRBA) was used to clarify NSDs role within global health. Literature reviews were conducted to ascertain the global disease burden, estimated global backlog, average cost per treatment, disability-adjusted life-years (DALYs) averted from the treatment, return on investment, and potential gain and economic impact of the NSDs identified. Six index NSDs were identified, including neglected cleft lips and palate, clubfoot, cataracts, hernias and hydroceles, injuries, and obstetric fistula. Global definitions were proposed as a starting point towards the prevention and elimination of the backlog of NSDs. Defining a subset of neglected surgical conditions that illustrates society’s role and responsibility in addressing them provides a framework through the HRBA lens for its eventual eradication.

Keywords


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