Summary of G4 alliance 19th Permanent Council Meeting 16th May 2026 (Part 1)
This year, the theme for the meeting was advancing SOTA care through technology, innovation and sustainable financing.
Technology and Innovation
We started with the technology and innovation panel, moderated by Prof Rick Henker. The first to present was Errol Norritz of Babson College, USA. Last September he took the post of executive director of Babson College’s Kerry Murphy Healey (KMH) Center for Health Innovation and Entrepreneurship. He spoke about their new program Global Surgery Slingshot. This course is filling a gap for surgical professionals in LMICs and takes approximately 5 months to complete. They aim to advance entrepreneurial thought and action by using measurable impact in global healthcare. Dr Norritz says “context matters in global healthcare”.
As part of this panel, we also heard from InterSurgeon partners, Ohana One. Peter Reneau, a medical engineer from Kenya, works with Ohana One. He helps provide equipment for online mentoring. They have two main virtual devices they use, televue which allows for multiple feeds on a low bandwidth and help lightning which is one feed only. They also provide smart glasses from Vuzix (which they find to be stable and robust) and portable ultrasound scanners (the size of a razor) from Vave to projects in Africa. They currently have a joint mission in InterSurgeon member MARCH in Nigeria. For their latest Kenyan project, Dr Kulber (plastic surgeon) is acting as mentor via the virtual technology to help assist surgeons to restore limbs to amputees. Changing the lives of many patients. Recently, they funded a neurosurgery mission to Senegal with Dr James Johnston (InterSurgeon founder and board chair) who was trialling the handheld USS in neurosurgery.
Ohana One run surgical site programs providing specialist training for surgeons, nurses and other disciplines such as OTs. Nurse Katie, a burns care nurse specialist has been training nurses in Kenya and Burundi for Ohana One on all elements of burns care management, e.g. fluid resuscitation training, as part of their program of expanding nurse educators. Currently they are also developing paediatric training courses. They encourage clinicians to sign up to the Ohana One app to be involved.
Next to the podium, Butterfly network which aim to provide democratic access to USS. Using a catalytic grant from The Gates Foundation, they have provided over 1000 devices to clinical workers in Kenya and South Africa. They also provide training including top use cases and AI education tools which shows real clinical impact. They currently work in over 115 countries with over 1000 partners.
From Global Strategy to WHA Action
Dr Lee Wallace and Dr Amelia Latu Afuhaamango Tuipulotu opened the session. They gave an update on the ECO (emergency, critical and operative care) resolution strategy, saying; “it plays a key role in health system access.” The document, currently being drafted, maps to 6 main global surgery areas; ECO governance and financing, ECO within models of care, ECO workforce and capacity building, ECO delivery and quality, ECO data for decision making and QI and ECO in public health emergencies and humanitarian crises. As they complete the global strategy, the next step is a global action plan with metrics and data (for late 2026) and then next year they will complete the global status plan. Dr Amelia, chief nursing officer of the WHO, is also focussing on the global strategic direction for nurses as there is currently a worldwide shortage of 5.8 million nurses. They are focussing on education, jobs, leadership and service delivery to “ensure the quality of care at the frontline.” This strategy has already been endorsed by member states and is being launched by the ministry of health in Nigeria. One of the methods of actioning these strategies is through the WHO academy which is “bridging the divide from data to policy to practice.” This is a currently a centre of excellence which is focussing on workforce strengthening, advocacy and partnerships.
G4 alliance update and WHA79 resolutions
New director, Colin McIff, has many years of experience at the WHA where he is well known. He co-authored resolution 78.15 with Professor Emmanual Makasa and he is very excited about “multi-lateral solutions” which will break down silos. This was a big theme at last year’s G4 alliance events which you can read more about on our news page. WHO are getting ready to elect a new director general. This process will take approximately one year with several stages including regional committee meetings later this year and then the executive board (early 2027) who will reduce the candidates to between 2 and 3 before the final vote takes place at WHA80.
At WHA79, the main items of global surgery itemised for member states to discuss are:
- Transplantation
- ECO care
- Primary healthcare
- Sustainable development goals (behind due to Covid pandemic)
- Recruitment of health workforce/migration of health professionals
- AMR gaps
- AI in the health sector
On the docket for January will be the G4 alliance TBI resolution (side event summary on our news page). Colin will continue to track new agenda items and engage with those. Natalie Sheneman, G4 alliance advocacy leader, developed a G4 alliance positional statement for WHA79, which can be viewed on their microsite (click here). G4 alliance are currently halfway through the long process to becoming a WHO non-state actor, which will help strengthen their position as a leading advocacy group.
Country focus: Practical lessons leading to country level engagement
Ghana is implementing their first NSOAP (national surgical, obstetric and anaesthesia plan). Their starting point was identifying a deficit in 1.25 million surgical procedures leading to preventable deaths, specialised clinicians being concentrated in cities and having a high out of pocket surgical cost despite a national health insurance scheme. In collaboration with mercy ships and operation smile, they have developed their NSOAP which is a roadmap with “data driven targets across 6 health systems.” The estimated cost of which will be $½ billion with diverse funding strategies built-in including project specific investments for PPPs (private public partnerships) which transfers systems to the state once they are set up and complete and bankable/ cofinancing projects which outline a return which enables the country to become self-reliant. They have set up the Ghana medical trust fund for patients which focusses specifically on treatments for chronic non-communicable diseases, specifically cancer and they are lobbying for more complex cases. This is not funding capped like the national health insurance plan. They aim to target specific capacity building and training (i.e. decentralised training). In this way they can make policy into practice which will reach the people of Ghana. They are engaging in telementoring and virtual diagnostic support to inform pre-operative planning, virtual communities of practice and G4 alliance and WHO co-sponsored project the OER (operative encounter registry) which will help maintain patient safety. This a great example of how WHO resolutions translate into country level engagement. The minister of health for Ghana said; “we need global ecosystems to move with us” and their NSOAP is the beginning; “we are turning blueprints into saving lives”.
The Ghanaian NSOAP project was nurtured by Irene Dzirasa, member of operation smile, as part of her project for the global surgery slingshot program (see above). With Mercy ships, they held a surgical dialogue meeting which engagemed many members of the surgical community including nurses, surgeons, ministries of health and finance, biomedical engineering departments and many more. Dr Johnathon Solani says; “all the key actors were in 1 room drawing and localising plans… [so that] people are taking ownership of the NSOAP”. The 3 main pillars for the NSOAP became workforce (increasing training), infrastructure (retooling of facilities including in-country manufactured items such as oxygen plants) and financing (rural incentive policies, free primary care and free vaccination programs eg HPV for girls aged 9-14 for forward planning). Whilst the advocacy for financing was difficult, they describe; “the biggest challenge was sustainable ring-fenced financing”.
In order to maintain the NSOAP, they have built in key indicators to monitor and assess surgical service development by improving data collection. In 5 years; “our key tenet is that anyone requiring surgical care should get it as close as possible to them and at minimal cost to them”. By engaging key surgical stakeholders, they aim to offer safe and timely surgical care to all. The G4 alliance November 2026 meeting will be held in Ghana.
