GSPU Advisory, Advocacy and Policy

GSPU hosted a hybrid symposium on Financing Global Cancer Care as part of London Global Cancer Week on 12 November 2024. The event comprised a series of talks on the projected burden of global cancer, the current financing of international cancer services, and how future funding can be secured, followed by discussion with the delegates. The following day Dr Hargest was invited to a round table discussion with representatives from ministries of health, cancer charities and providers, the Atomic Energy Authority and other commercial and governmental organisations to discuss the options for leveraging international funding to provide cancer services and to determine which aspects of cancer care can and should be included in national UHC packages.

Session recordings & presentations:

London Global Cancer Week - Financing Global Cancer Care, 12 November 2024 - Google Drive

The GSPU has been involved in several aspects of developing and implementing the WHO resolution WHA76.2 on Emergency Critical and Operative (ECO) Care. As well as undertaking research to provide evidence in how this resolution can be implemented and monitored, Dr Hargest and Dr Friebel were invited to moderate sessions at the Global Alliance for Care of the Injured meeting at the WHO in Geneva in June 2024. This important stakeholder group represents multiple healthcare organizations which are involved in providing care to injured patients worldwide, including Surgical and Anaesthetic Colleges and Associations, trauma nurses, ministries of health and representatives from accident prevention organizations.

Dr Friebel and Miss Hargest have been attending regular meetings of the WHO’s CSY partners for about 18 months and will now be included as full members as a result of the designation of the GSPU as a WHO Collaborating Centre.

The GSPU has provided training to representatives from the PSIN who have attended masterclasses at the RCSEng and LSE during May and September 2023. These events had an emphasis on value-based health care, funding strategies, transformational leadership and health service management.

The GSPU has been asked for advice by the Ministry of Health in Somalia and Vanuatu and the Ethiopian Federal Ministry of Health and by Einstein University, Sao Paolo, Brazil.

Due to religious, cultural and legal issues, women in Somaliland are unable to give consent for operation but have to rely on a male relative to do so. This is a particular problem with respect to consent for emergency Caesarean section as male relatives rarely attend hospital with their wives for issues related to childbirth. The expectant mother will usually be accompanied by a female relative, and it often takes a considerable period of time to locate an appropriate male relative and get him to attend the hospital and sign a consent form. It is not currently permissible for doctors to give consent on behalf of the patient in an emergency without risking legal challenge or even physical violence should there be an adverse clinical outcome.

The GSPU were therefore asked to collaborate with the Ministry of Health and women’s advocacy charities in Somaliland to try to develop a way forward to solve this problem. Interestingly, there is absolutely no appetite (even from the representatives of women’s organisations) for a wholesale change in the law to allow women to sign their own consent forms. A policy dialogue was held in September 2024 to look at the legal issues which prevail and to advocate with the legal representatives of the MOH to devise a way in which doctors could sign the consent form on behalf of a woman requiring emergency obstetric intervention, whilst being protected from litigation and legal challenge if acting competently and in good faith. There was a positive attitude and engagement from the senior ministry officials and lawyers who wish to pursue the option of an Emergency Obstetric Care Bill. Due to a change in Government following the election in November 2024, some of these individuals are no longer in post, but the main medical advisor has retained her position (and been promoted) and is a strong advocate for the rights of women in this regard.

The GSPU was invited to take part in a delegation which attended a reception at the House of Lords, organised by Baroness Finlay (pictured below left with Miss Hargest) who co-chairs the All-Party Parliamentary Group on Global Health, to advocate for investment in children’s surgery as part of the UK’s international development agenda. Partners in this event included Kids OR charity, Incision, the department of Paediatric Surgery in Oxford, and the Global Surgery Unit in Brimingham University.