Development of Sustainable Global Thoracic Surgery Programs in LMICs

Abstract

The development of a sustainable general thoracic surgery program in low-and middle-income countries (LMICs) requires closely coordinated multidisciplinary capacity building. Human and material resources for case finding and work up (radiology), intraoperative care (anesthesia), and postoperative management (critical care, pathology, oncology) are necessary to facilitate care of patients with general thoracic disorders. Here we review (1) the epidemiology of thoracic diseases treated with surgery, (2) barriers and solutions to capacity building, and (3) several examples of successful surgical programs that have served to not only provide general thoracic capacity but also strengthen the local health system overall.

Healthcare sustainability in cardiothoracic surgery

“…Most previous studies reference the United Nations 2015 Sustainable Development Goals framework and focused on the third tenet of 'Good health and Well-being', emphasizing the need for availing cardiothoracic capabilities to countries with limited access. [28][29][30] What these studies potentially neglect is that good environmental stewardship can pre-emptively negate the need for provision of specialty access as a downstream consequence. 7,8 Air pollution has been proven to be associated with cardiovascular disease 31,32 and PM 2.5 exposure even labelled as a modifiable factor by the American Heart Association.…”

“…It would be remiss to say that cardiothoracic as a whole has not attempted to address the broad issue of sustainability. Most previous studies reference the United Nations 2015 Sustainable Development Goals framework and focused on the third tenet of ‘Good health and Well‐being’, emphasizing the need for availing cardiothoracic capabilities to countries with limited access 28–30 . What these studies potentially neglect is that good environmental stewardship can pre‐emptively negate the need for provision of specialty access as a downstream consequence 7,8 .…”