Ecuadoran VP Promotes Global Surgery and Health Equity

HMS visit highlights collaboration, integrated approaches

In a hallway painted with colorful geometric patterns, two men in suits stand on either side of a portrait of a man in surgical gowns reviewing an X-ray of a patient’s skull. The portrait is labeled “Harvey Cushing.”
HMS’ Kee Park and Ecuadoran Vice President Alfredo Borrero, both neurosurgeons, stopped to honor the legacy of neurosurgery pioneer Harvey Cushing at Brigham and Women’s Hospital. Image: PGSSC

In 2021, as he was campaigning to be elected vice president of Ecuador, Alfredo Borrero traveled more than 50,000 kilometers around his nation, he said, to better understand the lives of the people he wanted to serve.

He visited places with no clean drinking water, no roads, little opportunity for work, and severely limited medical resources.

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Borrero’s four decades of work as a doctor, medical educator, and hospital leader, and the experiences he had on the campaign trail, reinforced for him the need for a comprehensive approach to improving the health and well-being of the people of Ecuador.

That meant not only improving the country’s health care system and providing better preventive care in the form of vaccinations and improved access to surgical care, but also facilitating improvements in infrastructure, nutrition, and education.

Borrero had been drafted to run for political office after a lifetime of practicing surgery, launching a medical school, and running a hospital. But coming from a career in neurosurgery, he saw a particular imperative to address unmet needs for surgical care in Ecuador.

“Surgery is a must-have,” Borrero said. “When you need it, you need it right away.”

Borrero was not alone in his thinking. In 2015, the Lancet Commission on Global Surgery helped launch a growing movement to improve access to crucial surgical care for all the world’s people.

The commission issued a report that found that 5 billion people are unable to access safe, timely, affordable surgery and anesthesia, leading to 18.6 million preventable early deaths each year.

To meet these needs, the researchers calculated, an additional 143 million more surgical procedures were needed annually around the world.

The study found that surgery can both be affordable and an excellent return on investment, even though many global health advocates continue to see it as a luxury item, something nice to have once the more common, or more affordable, options are taken care of.

Harvard Medical School collaboration

As part of Ecuador’s efforts to address the issue, Borrero met with leaders, researchers, students, fellows, and clinicians on April 10 and 11. He was hosted by the Program in Global Surgery and Social Change (PGSSC), a part of the Department of Global Health and Social Medicine in the Blavatnik Institute at Harvard Medical School. Borrero also visited Brigham and Women’s Hospital’s Neurosurgery Department, Boston Children’s Hospital’s Innovation and Digital Health Accelerator, and Harvard Business School.

The visit was part of an ongoing collaboration between Ecuador and HMS, centered on Borrero’s interest in global surgery and his desire to find new ways to support comprehensive, equity-focused efforts to improve the health and well-being of Ecuadorans.