Frugal Innovation for Global Surgery

Leveraging lessons from low- and middle-income countries to optimize resource use and promote value-based care

A Steyn, A Cassels-Brown, DF Chang, H Faal, R Vedanthan, R Venkatesh,  CL Thiel
Royal College of Surgeons England – The Bulletin July 2020


Minimizing the footprint of cataract surgery: a blueprint for surgical sustainability.

Limited or inconsistent access to necessary resources creates many challenges for delivering quality medical care in low- and middle-income countries (LMICs). These include funding and revenue, skilled clinical and allied health professionals, administrative expertise, reliable community infrastructure (eg water, electricity), functioning capital equipment, and sufficient surgical supplies. Despite these challenges, some surgical care providers manage to provide cost-effective, high-quality care, offering lessons not only for other LMICs but also for high-income countries (HICs) that are working towards increasing value-based care. Examples would be how to optimize the consumption of resources, and reduce the environmental and public health burden of surgical care.

Owing to the liberal utilization of capital equipment and single-use supplies, surgical care in HICs is increasingly recognized as a significant source of greenhouse gases and other environmental impacts that adversely affect human health. Regulations require many potentially reusable supplies and drugs to be discarded after single use. Supply manufacturers may label drugs or products as single-use to increase profit, reduce liability, or facilitate regulatory approval. Many HICs struggle to increase the value of care while maximizing quality and outcomes and minimizing cost and resource use…

Read the full article (p198) in the RCS Bulletin July 2020>