Digital Surgery has invested over 10 million dollars to support access to safer surgery for over 5 billion patients

Digital Surgery launches new surgical simulations for global surgery at the United Nations General Assembly

In economics, there is a point on the supply and demand curve where markets are said to be “optimized.” That is – the amount of goods or services being demanded by buyers is equal to the quantity supplied by sellers. At this intersection, everyone is assumed to be satisfied. After all, buyers have purchased what they want, at a price that they can accept, and sellers have cleared their goods, at a price that is economically viable.

In health care markets, patients need care, thus creating demand, and health systems, including manufacturers of medical devices, operators of hospitals, and clinicians, provide care, thus creating supply. Aside from the broader debate of whether or not the laws of economics can be applied to describe healthcare markets, it doesn’t take a trained economist to see that when it comes to potentially life-saving surgical care, the healthcare market is very broken.

Let’s look at the facts:

  • Over 5 billion people – more than half of the world’s population – do not have timely access to affordable and safe surgical care. (Lancet 2015)
  • Surgical conditions account for about 30% of the global burden of disease. To put this into context, in 2010, an estimated 16.9 million lives were lost from surgical conditions. This figure  surpasses, by a considerable margin, the number of combined deaths from HIV/AIDS (1.46 million), tuberculosis (1.20 million) and malaria (1.17 million). (Lancet 2015; Lancet 2012)
  • In low- and middle-income countries, 90% of patients – that’s 9 out of 10 people – can’t access basic surgical care. (Lancet 2015)
  • For 82 million individuals, accessing surgical care means plunging the family into poverty. (Lancet 2015)

Patients and their families need surgical care, and the demand, mostly concentrated in low- and middle-income countries, is significant. In fact, it’s estimated that 143 million additional procedures – around 1.5 times the estimated volume of surgeries performed annually in the US – must be delivered every year to meet basic needs around the world. And yet, in many countries, this demand remains unmet, due to reasons of insufficient healthcare infrastructure, limited surgical workforce, or payors (patients or governments) lacking the financial means for pay for care.

The healthcare market is very broken when it comes to surgery, and with grave implications. When surgical care is not readily available, easily treatable conditions become fatal. When emergency Caesarean Sections (C-Section) are unavailable, death is the most common outcome for both mother and infant. When repairs and reconstructive surgeries are inaccessible, cleft lip and palate become impediments for normal childhood growth and development. When injuries are not promptly attended to, lifelong disability prevents the patient from being able to provide for his future family. As suppliers and members of the global citizenry, it’s our fiduciary duty to our shareholders and our social responsibility to each other to invest in these emerging territories and address unmet demand.

Corporate stakeholders will point out that resource-constrained settings represent risk. Low affordability and “institutional voids” make entry and long-term success difficult. Whilst it’s true that entering a new market is inherently risky, the reality is that, without entry into emerging markets, established companies are unlikely to remain competitive for long. Anecdotally, Johnson and Johnson’s (JnJ) entry into China is heralded as a success story for investing early, with significant payoffs. The company entered China in the late 1970’s, being amongst the first wave of multinational companies to invest in building the Chinese market after its economic opening. What started as a technology-transfer in 1979 to build a chemical factory has evolved to include a JV (Xi’an-Janssen, the company’s pharmaceutical arm) and a horizontal expansion to introduce a full portfolio of products, including consumer goods, medical devices, and a large R&D Center focused on developing products for local consumers. Today, JnJ’s success in China serves as a reminder that early entry into promising emerging territories and investment to build local capacity can deliver long term success.

Five years ago, when we first started Digital Surgery (most well-known for our flagship product, Touch Surgery), we made the decision for Touch Surgery to be made available free of charge. Our hope was and still is, to this day, to improve the training and delivery of surgery, so that patients can access high-quality care. Since then, we’ve invested in building over 200 simulations across 15 different surgical specialties, with a significant portion of simulations being suitable training aids in resource-constrained settings. In-line with global mobile usage patterns, we’ve also invested in building an Android product to ensure accessibility outside of the US and Europe. We’ve been validated by more than 15 independent, peer-reviewed publications as being an efficacious mobile-based training tool. As a result of our investments thus far, our user base from non-OECD countries is large and growing, accounting for more than 30% of our global 2.5 million users.

More excitingly, we’ve spent the last two years developing our new in-Operating Room (OR) product, GoSurgery, which uses Artificial Intelligence (AI) to deliver the right information to the right team member, at the right time. When combined, we believe Touch Surgery and GoSurgery can help low- and middle-income health systems leapfrog into a new era of digital and AI-enabled surgical care.

This week, we are proud to be attending the Access Challenge event in New York, as a partner to Assist International and Dalberg in the Safe Surgery 2020 Initiative. Assist International is a non-for-profit organization which designs and implements humanitarian programs in global health. Launched in 2015 with support from the GE Foundation, Safe Surgery 2020 aims to reduce maternal and trauma-related mortality in low-and middle-income countries. As part of the event, we’re launching a series of new content, including simulations for C-Sections and hysterectomies, to demonstrate our continued investment in global surgery. C-Sections are considered major surgery, with potential long term effects, which are necessary when certain complications arise during pregnancy and labour. Globally, almost 1 in 5 women in the world now give birth by C-Section, hence creating urgency around reliable and low-cost training solutions for healthcare providers.

But we can’t do it alone. The Lancet Commission on Global Surgery highlighted a series of action points for the international community to support the realization of safe global surgery, chief amongst them is to provide targeted health system financing to meet local demand and continued investment in workforce development. We’d like to extend a formal call-to-action to our medical device partners, as well as professional associations and charitable organizations. If a small start-up like ours can make a difference for patients by investing to build the market, imagine what more we can do together. If you haven’t yet reached out to us to create simulations and training aids, we’d love to work with you to grow the digital tool kit for global surgery.

For more reasons than one, the law of supply and demand is a flawed lens by which to examine the market for health and surgical care. For us at Digital Surgery, investing in global surgery comes down to one simple truth: Everyone should have access to safe, affordable and timely surgical care.