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Rising to the Challenge of Global Surgery: Basic Science or Basic Surgery?. UCSF Surgery Grand Rounds January 31, 2007 John Ziegler MD MSc Rochelle Dicker MD William Schecter MD Jennifer Wang MD Doruk Ozgediz MD MSc. Global Health: Where are we now?. More $ for Global Health.
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Rising to the Challenge of Global Surgery:Basic Science or Basic Surgery? UCSF Surgery Grand Rounds January 31, 2007 John Ziegler MD MSc Rochelle Dicker MD William Schecter MD Jennifer Wang MD Doruk Ozgediz MD MSc
More $ for Global Health • US Development Assistance • $11 to 28 billion (2001-2005) • PEPFAR (2003) $15 billion over 5 years • Global Fund for HIV/TB/Malaria (2002) • $3 billion over 3 years • World Bank: $2 billion (2006) -> health • Gates: $6.6 billion/ 6 years • Buffett: to add $1.5 billion/yr
Global Burden of Disease • Murray/Lopez 1996/2006 • 230+ conditions • Three Groups • Communicable • Non-communicable • Injuries • Mortality + Morbidity • “Disability-Adjusted Life Year” (DALY) • 90% BOD in Developing Countries
Composition of Burden of Disease (% DALYS) Lopez et al. (2006) Global Burden of Disease and Risk factors Oxford U. Press
Disease Control Priorities in Developing Countries (2006) • Surgical Conditions: 50% BOD • Cost-effectiveness of interventions • Measles Vacc.: $1-5/DALY averted • ARV’s for HIV: $300-500/DALY averted • Surgery: $7-200/DALY averted
Challenges to Global Surgery • Priority • Workforce • Infrastructure • Finance
“Translational” Research • Bench -> bedside • Bedside -> population
Learning Objectives • Burden of Cancer in Developing Countries • Burden of Injury in Developing Countries • Uganda • Historical and Contemporary Perspectives • FAST study • Conclusions-> The way forward