Rising to the challenge of global surgery basic science or basic surgery
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Rising to the Challenge of Global Surgery: Basic Science or Basic Surgery?. UCSF Surgery Grand Rounds January 31, 2007 John Ziegler MD MSc Rochelle Dicker MD William Schecter MD Jennifer Wang MD Doruk Ozgediz MD MSc. Global Health: Where are we now?. More $ for Global Health.

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Rising to the Challenge of Global Surgery: Basic Science or Basic Surgery?

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Rising to the challenge of global surgery basic science or basic surgery

Rising to the Challenge of Global Surgery:Basic Science or Basic Surgery?

UCSF Surgery Grand Rounds

January 31, 2007

John Ziegler MD MSc

Rochelle Dicker MD

William Schecter MD

Jennifer Wang MD

Doruk Ozgediz MD MSc


Global health where are we now

Global Health:Where are we now?


More for global health

More $ for Global Health

  • US Development Assistance

    • $11 to 28 billion (2001-2005)

    • PEPFAR (2003) $15 billion over 5 years

  • Global Fund for HIV/TB/Malaria (2002)

    • $3 billion over 3 years

  • World Bank: $2 billion (2006) -> health

  • Gates: $6.6 billion/ 6 years

    • Buffett: to add $1.5 billion/yr


Global burden of disease

Global Burden of Disease

  • Murray/Lopez 1996/2006

  • 230+ conditions

    • Three Groups

      • Communicable

      • Non-communicable

      • Injuries

    • Mortality + Morbidity

      • “Disability-Adjusted Life Year” (DALY)

  • 90% BOD in Developing Countries


Rising to the challenge of global surgery basic science or basic surgery

Composition of Burden of Disease (% DALYS)

Lopez et al. (2006) Global Burden of Disease and Risk factors Oxford U. Press


Disease control priorities in developing countries 2006

Disease Control Priorities in Developing Countries (2006)

  • Surgical Conditions: 50% BOD

  • Cost-effectiveness of interventions

    • Measles Vacc.:$1-5/DALY averted

    • ARV’s for HIV: $300-500/DALY averted

    • Surgery: $7-200/DALY averted


Challenges to global surgery

Challenges to Global Surgery

  • Priority

  • Workforce

  • Infrastructure

  • Finance


Translational research

“Translational” Research

  • Bench -> bedside

  • Bedside -> population


Learning objectives

Learning Objectives

  • Burden of Cancer in Developing Countries

  • Burden of Injury in Developing Countries

  • Uganda

    • Historical and Contemporary Perspectives

    • FAST study

  • Conclusions-> The way forward


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