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Low- and middle-income countries (LMICs) are disproportionately affected by surgical pathologies. However, most authors of current global surgery publications are not from LMICs, and high-income country authors are overrepresented in lead and senior author positions. Several nonprofit organizations have championed novel models for equitable research partnerships to address these disparities. While progress has been made, further advances may be accomplished by engaging medical students, residents, and trainees early in their education and career development. We propose a research framework that emphasizes the principles of equity and integrity to enhance the knowledge of medical students, residents, and trainees, ultimately empowering them to serve as equitable partners in global surgery.

Introduction The Zaatari refugee camp in Jordan hosts over 80,000 displaced Syrians, many with musculoskeletal needs. Despite this burden, camp-based surgical capacity has not been systematically assessed. We aimed to evaluate orthopaedic care capacity across Zaatari health facilities using an adapted Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) framework. Methods A cross-sectional survey was conducted in April 2025 across five of six full-time health facilities in the Zaatari refugee camp, including four outpatient clinics and one emergency department. Data were collected in person from clinic managers, emergency department providers, and an orthopaedic surgeon using an adapted PIPES framework modified to emphasize musculoskeletal procedures, fracture management, and resources relevant to trauma care. This adapted version has not been validated. Results Zaatari facilities demonstrated markedly constrained orthopaedic service capacity. No facility reported an operating room, anaesthesia machine, anaesthesia provider, blood bank, intensive care unit, or orthopaedic implants. Fracture care was limited primarily to immobilization and splinting, while definitive fixation, fasciotomy, skeletal traction, and operative fracture management were unavailable. Basic consumables such as gloves, intravenous fluids, syringes, and sutures were generally available, but advanced imaging and operative equipment were absent. PIPES indices ranged from 3.7 to 5.7 across camp facilities with a mean of 4.9. Conclusion Health facilities in Zaatari had basic capacity for wound care, splinting, and limited outpatient orthopaedic services, but no on-site operative orthopaedic capability. These findings identify practical service gaps in fracture management, anaesthesia, operative infrastructure, and trauma care for refugees in a protracted camp setting.

Introduction: The rate of operating-theatre room nosocomial infections is estimated at 10% of surgical site infections (SSI) in postoperative wounds. Earlier studies have suggested that restricting traffic by head count and reducing the number of door-openings of the operating room could reduce the development of SSI. This study was done to determine whether traffic in theatre by head count or door-openings was a risk for the development of SSI. Methods: This was a prospective observational cohort study conducted at 3 tertiary hospitals in the Copperbelt Province of Zambia. Results: A total of 1122 participants were included. Of the total study population, 468 were females and 654 were males. A total of 218 participants, representing 19.4%, developed surgical site infection proven by pus results. This study showed no association between the number of people by head count in the operating theatre and the development of SSIs. All p-values for head counts were not significant. However, the number of door-openings was significantly associated with the risk for development of SSI. Conclusion: The prevalence of SSI at the 3 tertiary institutions was 19.4%. An increased number of door-openings was significantly associated with SSI.

On May 3rd, 2025, the 13th Annual Global Surgery Conference gathered 158 participants from 23 countries under the theme of Equity in Global Surgery. Organized by the McGill Chapter of the Canadian Global Surgery Trainees’ Alliance (CGSTA) in collaboration with the McGill Centre for Global Surgery (CGS), this hybrid event aimed to reimagine global surgery education through principles of inclusion, decolonial practice, and shared leadership. The program featured keynote lectures, trainee research presentations, and a disaster-response case competition. Voluntary pre- and post-conference surveys (n=45) suggested increases in participants’ self-reported understanding of global surgery, confidence in pursuing related opportunities, and awareness of equity-oriented strategies. Mean knowledge scores increased from 3.16 to 4.12 (+0.96), with the largest gains in familiarity with global surgery programs (+1.17) and confidence applying for related opportunities (+1.23). As responses were anonymous and unpaired, findings are descriptive and exploratory. This hybrid and low-cost conference model led by trainees offers a practical framework for advancing equity and engagement in global surgery education.

Africa faces a US$66 billion annual health financing gap, compounded by a sharp decline in official development assistance and persistent constraints on domestic public expenditure. While domestic allocation remains central to health financing, it alone cannot compensate for this critical gap. Blended finance, the strategic use of public or philanthropic capital to mobilize private investment for development outcomes, presents a credible opportunity to narrow this gap in parallel with increased domestic allocations.

This commentary examines how existing platforms in Africa could advance blended finance for health. The Program for Investment and Financing Africa’s Health Sector (PIFAH) serves as a continental platform for pipeline development and investment structuring, offering AU endorsement, government buy-in, and a pool of bankable health investment opportunities through its Health Market Atlas. This creates a fertile ground for collaboration with health-focused blended-finance initiatives such as the Transform Health Fund (THF), which bring the financial structuring expertise and an established track record needed to attract development finance institutions and private investors to health.

We argue that PIFAH’s sovereign-anchored pipeline, when overlapped with health-focused blended finance facilities like THF, can generate the early evidence needed to establish African health markets as a credible destination for commercial capital. While structural risks around equity, governance, and capital concentration require deliberate design, an operational framework anchored by PIFAH linking the Health Market Atlas to a cohort of facilities could offer a scalable and replicable pathway to strengthen private capital-supported health financing that neither public platforms nor blended finance facilities can mobilize alone.