Concept Note

For more information, please see the Interview with Pr. KH Yangni-Angate

MAIN THEME – Building a sustainable system for permanent development of Open Heart Surgery in Africa:  the way forward after 2019 Abidjan Declaration

SUB -THEMES:
1. The role of cardiac surgery in Global surgery and Global health in Africa
2. Recent Advances and Innovations in Vascular Surgery
3. Thoracic Surgery: Modern techniques, Challenges and Results

The incidence of cardio-thoracic diseases is increasing in Sub Saharan Africa (SSA). Deaths attributable to cardio-vascular disease (CVD) are over 17 million, accounting for 31% of total global mortality, with rheumatic heart disease over 325,000 and congenital heart diseases over 280,000; to tuberculosis over 1.5 million; esophageal cancer over 440,000; and over 1.1 million due to road traffic accidents. More than three deaths out of 4 caused by cardiovascular diseases happen in countries with low or middle income including Sub-Saharan Africa where those incidences of death continue to rise up. The highest prevalence of rheumatic heart disease in the world is found in Sub-Saharan Africa in children aged 5 to 14 years at 5.7 per 1000; there are 2 million children with rheumatic heart disease worldwide, including 1 million in sub-Saharan Africa. Nevertheless, rheumatic heart disease is the leading cause of children ‘death during the first 10 years of life with a mortality rate of 12.5% to 20%'; among the deceased, many could have been saved if there were easy access to Open Heart Surgery; among the survivors, hundreds of thousands cannot access Open-Heart Surgery and will see their physical condition deteriorate until early death. Moreover, CVD including Rheumatic heart and congenital heart diseases have a negative impact on the economies of low- and middle-income countries. They would reduce the gross domestic product (GDP) of these countries, which are experiencing rapid economic growth of 1 to 5% because many people die prematurely due to lack of access to cardiac surgery. In fact, in SSA, CVD contribute to household poverty. 

The same catastrophic picture has been described for surgical care delivery at large in LMIC. Based on this fact, in May 2015 the World Health Assembly (WHA) passed the resolution 68.15, Emergency and Essential surgical Care and Anesthesia (EESC&A); In February 1st-3rd 2017 In Addis Ababa (Ethiopia), the Pan African Association of Surgeons (PAAS) had organized an international conference in collaboration with African Union Commission (AUC) on “Global Surgery Implementation in Africa” in line with the African Union agenda in 2063 , 2024 STISA, Lancet commission key messages on global surgery, and WHA resolution. 

Surgery overall and cardiac surgery in particular have an essential role to play in preventing death and disability and improving the health of communities. What has now been recognized is that in LMIC’s, there is a significant unmet need with regards surgically treatable conditions. The consequence of this is an increased burden of disability and increased poverty. It has been estimated that up to 15% of all deaths are due to surgically preventable conditions. Adequate access to Surgical Care has the potential to enhance the economies of LMIC’s. 

From Lancet Commission initiatives for NSOAP expansion in LMIC’s and others such as the Pan-African Association of Surgeons' action-plan, West African college of surgeons NSOAP scheme, Ivorian Society for Thoracic and Cardio-Vascular Surgery (ISTCVS ) action for OHS development in SSA and according to 2019 ABIDJAN DECLARATION FOR OPEN-HEART SURGERY DEVELOPMENT AND FINANCING IN SUB-SAHARAN AFRICA, the African Association of Thoracic and Cardio-Vascular Surgeons (AATCVS) has decided to invite all health practitioners in Africa and all over the world for an international conference on Global cardiac surgery implementation in Africa to gather in Abidjan in February 2021 and to mobilize all global surgery expertise, health human resources in and outside Africa: individuals such as, surgeons, obstetricians and gynecologists, anesthesiologists, public health care providers, nurses, health technicians, scientific societies, surgical colleges and other training institutions for moving forward 2019 Abidjan declaration for OHS development in Africa and bringing together all surgeons for discussing on their respective experiences on NSOAP that can help global cardiac surgery implementation in Africa; AATCVS’ aim is to link with ECOWACS, WAHO and African Development Bank and African Union Commission and international organizations worldwide for starting, according to African Union Agenda 2063, SDGs and Universal health Coverage, work towards access to Open Heart Surgery for all African Populations.