Conference report: NIHR Global Surgery Unit: Mexico 2024

The NIHR Global Surgery Unit (GSU) Annual Prioritisation Meeting marks a new year for the global surgery network. It provides a face-to-face interaction between members of the network and is an avenue to discuss and prioritise research relevant to patients. This year it was held in Cancun, Mexico, from 9th to 11th September, bringing together 167 participants from diverse countries, including Benin, Colombia, Gabon, Ghana, Guatemala, India, Nigeria, Rwanda, South Africa, the United States, England, and Scotland.

The event began with a review of the GSU’s achievements over the last decade, including its contributions to global cohort studies, influential clinical trials, and practice-shaping guidelines. Highlights of the research portfolio included advancements in green surgery, surgical technology, access to surgery, peri-operative care, wound infection, and surgery during the COVID-19 pandemic. The network's Hub and Spoke model, which delivers high-quality, patient-level data research, has enabled these successes. Each hub’s specific achievements were shared in a video presentation.

As the unit looks ahead, discussions revolved around the future trials and cohort studies planned for the next few years. Cross-cutting themes such as capacity building, policy influence, and women in leadership were identified as key priorities.

Four major trials were presented:

The large collaborative prospective cohort studies carried out by the unit lay firm foundations and provide background data for future clinical trials.

Two large prospective cohort studies were also discussed:

We had an overview of the Wellcome LEAP SAVE(Surgery: Assess / Validate / Expand) program. The program aims to address two specific barriers of optimal surgical care: lack of surgically care providers and post-operative complications. Its main goals are to develop capability of training non-MD surgeons to deliver laparoscopic surgical care with comparable outcomes to MD surgeons, to shorten the time required for surgical training through simulation tools that accelerate skills with objective assessment of competence, and lastly to decrease postoperative complications and mortality by at least 50% through advanced improved physiological monitoring and early identification of patients at risk. The team delved into two main domains of accelerating skills acquisition and objective assessment of surgical performance both during simulation and in the operating theatre.

Engaging policy makers is crucial to ensure the adoption and scaling of research findings. Representatives from the Mexican Association of General Surgery (AMCG), the Mexican Association of Endoscopic Surgery (AMCE), the Latin American Federation of Surgery (FELAC), Mexican Hepato Pancreato Biliary Association (AMHPB) and the Latin American Federation of Surgery (FELAC) participated in discussions about how to influence local, national, and international policies. One of the key strategies discussed was moving stakeholders—such as the World Health Organization (WHO)—from awareness and interest to action. Calls were made for increasing the representation of LMIC providers in health policy development to improve equity in global surgery.

The role of women in surgical research leadership was another central topic. A group of 26 women with clinical academic roles discussed the role of women in surgical research leadership positions. The findings from a questionnaire previously circulated within the wider team were discussed and future themes were prioritised.

Key points from these discussions included:

Capacity building has long been an integral part of the GSU’s strategy. The annual prioritisation meeting provided a unique opportunity to offer face-to-face training and support for individual projects. Training sessions were conducted in a drop-in format, allowing participants to seek advice and insights into their specific research interests. These sessions included Implementation science and behavioural change, Statistics and Health economics.

The 2024 NIHR Global Surgery Unit’s annual meeting provided an important platform for reflection, planning, and collaboration. The network’s achievements over the last decade demonstrate the value of its Hub and Spoke model, while plans for future trials, cohort studies, and initiatives promise to make significant impacts on global surgery, particularly in low- and middle-income countries. With continued focus on technology, capacity building, policy engagement, and equity in leadership, the GSU is well-positioned to meet the surgical challenges of the next decade.

For further information, please visit https://www.globalsurgeryunit.org/ or contact us at enquiry@globalsurg.org.

Funding: The work presented is funded by a National Institute for Health and Care Research (NIHR) Global Health Research Unit Grant (NIHR 133364) and an advanced clinician scientist award from the NIHR Academy. The views expressed are those of the authors and not necessarily those of the NIHR or the UK Department of Health and Social Care.

Acknowledgements: Many thanks to the Mexico Hub team for the organisation of the main event in Cancun and the side events in Veracruz.