On November 19, I attended an event commemorating the life and legacy of Dr Paul Farmer, a man whose work transcended borders and professions to redefine what is possible in global health.
As stories of his remarkable contributions unfolded, one fact stood out: Paul Farmer was not a surgeon, yet his vision has transformed the future of global surgery.
Farmer’s approach to justice and accompaniment challenges us to see surgery not just as a medical intervention, but as a moral imperative and a pillar of equity.
Farmer’s legacy is not confined to the past. It is a call to action, urging us to reimagine global surgery as a collaborative endeavour where contributions come not only from surgeons but also from policymakers, engineers, educators and advocates.
The future of global surgery depends on this collective effort to build systems that ensure safe, timely and affordable surgical care for everyone, everywhere.
Dr Farmer’s influence on global surgery lies in his ability to bridge the gap between systemic challenges and human needs. His principles of accompaniment and equity offer powerful lessons for shaping the future.
Walking alongside communities to build sustainable systems, he emphasised strengthening healthcare infrastructure, empowering local healthcare workers and addressing barriers like transportation, housing and fi nancial insecurity.
He reframed surgery as a fundamental human right, challenging the global health community to recognise that the inability to access surgical care is not just a technical gap but a profound moral failing.
For Farmer, the path to sustainable progress was not about individual heroics, but about building systems that endure, ensuring that surgical care becomes scalable and equitable.
As we honour Farmer’s legacy, the question now is: how do we take his principles forward to shape the future of global surgery? The answer lies in embracing interdisciplinary collaboration, where non-surgeons play a pivotal role alongside surgeons.
Policymakers must integrate surgery into Universal Health Coverage agendas, while engineers and technologists develop innovations like telemedicine platforms, AI-powered diagnostics and portable surgical tools.
Economists and health system planners can design sustainable financing models, such as endowment funds and global health bonds, to support surgical programmes.
For example, in Rwanda, interdisciplinary teams—including public health professionals and data scientists—scaled surgical access under Farmer’s guidance, creating a model for systemwide change.
Technology will also be critical in democratising surgical care. Telemedicine can enable remote surgical training and consultation, reducing workforce shortages.
Innovations like 3D printing can provide affordable tools and prosthetics for resource-limited settings, while AI-powered triage systems can help identify patients most in need of surgical intervention, ensuring timely care. But technology alone is not enough.
Advocacy efforts must address the upstream determinants of surgical inequity, lobbying for government investment in National Surgical, Obstetric and Anesthesia Plans and strengthening partnerships between governments, NGOs and the private sector to fund infrastructure and workforce development.
Ultimately, global surgery is about people. Stories of patients who have been denied life-saving care due to systemic inequities must become central to advocacy. These human stories make the consequences of inaction undeniable, driving policy change and inspiring collective action.
As I reflect on the event honouring Dr Paul Farmer, I am struck by how his work inspires not just admiration but also responsibility.
His life challenges all of us— whether surgeons or not—to become advocates for justice, to stand in solidarity with those who lack access to care and to push for systemic change.
In my own work, Farmer’s principles resonate deeply. They remind me that the fight for equitable surgical care is not confined to the operating room but extends to boardrooms, community centres and policy arenas.
His vision of accompaniment calls us to go
beyond temporary solutions, ensuring that the systems
we build today will serve generations to come.
