The National Institute for Health and Care Research (NIHR), the largest leading body for clinical & public health, social care, and translational research is conducting its annual meeting in Delhi on 26th and 27th of September. The aim of the conference is to discuss the importance of ‘Research in Surgery’ in India and across the globe. 

Access to surgery is an essential component of health systems but has generally been neglected. There is a large unmet need for surgical care worldwide, with surgical conditions and treatments being poorly resourced, the COVID-19 pandemic has further accentuated the challenges associated with access and provision for essential surgery.  

The two-day meeting in the city is organized in collaboration with the University of Birmingham, Christian Medical College Ludhiana, and Birmingham Clinical Trials Unit (BCTU) with an overarching aim to increase quality and standards of surgical care globally and especially in Lower Middle-Income countries (LMICs). It is found that where surgery is available, patients are 3 times more likely to die in LMICs after the operation than in high-income countries thus the NIHR aims to save lives through realistic and cost-effective solutions. 

Speaking at the meeting, Professor Dion Morton, Colorectal Surgeon, Barling Chair of Surgery and Co-Director NIHR Global Health Research Unit on Global Surgery, University of Birmingham, said, “We conduct annual research prioritisation events such as this to allow surgeons from all over the world to establish the priorities and solutions for the network. We focus on advocacy, education, research, and clinical interventions. Working across clinical disciplines with surgeons, anesthetists, nurses, other healthcare professionals, and non-clinicians including policymakers, epidemiologists, and economists, as well as patients and community members we adopt an all-inclusive – top-down and bottom-up approach to engineer change. While the scope for research in surgery is vast and the impact crucial, it is our endeavour to communicate this hard-core grass-root data to the people, policymakers, and influencers to create a change in mindset and promote international and local funding.”

Addressing the NIHR global hub directors and other industry peers at the inauguration, Prof Parvez David Haque, General Surgeon, HOD Department of General Surgery, Hub Lead, NIHR Global Health Research Unit on Global Surgery; CMC & Hospital Ludhiana, said, “The biggest achievement by us at the India Hub is currently our network. The India Hub leads and coordinates research at 101 Indian hospitals which include clinical trials at 25 hospitals and cohort studies at 76 hospitals across India. Our partner hospitals include large urban hospitals and teaching institutions as well as smaller remote hospitals giving an accurate representation of the population case mix in India. We are working toward becoming more self-reliant than before and aim at collaborating with more partners. Research in surgery is important now more than ever post the pandemic as 1/3rd of the diseases are caused due to lack of appropriate post-operative care. With the right resources, NIHR can make a great impact on mortality rates post-surgery in India.”

The speakers at the meeting included senior officials from the Indian Council of Medical Research (ICMR), the British High Commission, the Public Health Foundation of India, and the Association of Surgeons of India (ASI) who addressed areas of concern such as – surgery as a primary determinant of good healthcare, surgery and its importance in healthcare policy and healthcare delivery in India, and delivery of good paediatric surgical care for children with congenital disability as well as Sustainability, Equity, Diversity, and Inclusion in global surgery. 

Speaking on the importance of sustainability in surgery, Dr Dhruva Ghosh, Paediatric Surgeon – CMC Hospital Ludhiana, India Hub Director at NIHR Global Health Research Unit on Global Surgery, said , “The NIHR team recently conducted the first sustainable, zero-emission surgery in Birmingham, UK. Sustainable practices in surgery are crucial in research in surgery and its future. As operating rooms remain the most polluting zones in a hospital, it is essential to adopt measures to reduce carbon footprint in healthcare and bio-medical waste generation. These sustainable practices in surgery not only contribute to giving back to the environment but also are economically and practically feasible for LMICs.”

Speaking about future measures, Mr. Aneel Bhangu, Colorectal Surgeon, NIHR Clinical Scientist in Global Surgery,  the University of Birmingham, said, “Currently, at least 4·2 million people worldwide die within 30 days of surgery each year, and half of these deaths occur in LMICs. Therefore, there is a pressing need to expand surgical services to underserved populations in tandem with initiatives to reduce postoperative complications. I think it is imperative that funders and policymakers must prioritize research that aims to make surgery safer.”

The NIHR GSU hub in India is based at Christian Medical College & Hospital, a 125-year-old institute in Ludhiana, Punjab and seeks to establish collaborations with surgeons, researchers and scientists in India to improve outcomes of surgical and post-operative care.

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