Anna Dare

Surgical Oncologist, Division of General Surgery, St. Michael’s Hospital 
Global Surgery Lead, Department of Surgery, University of Toronto  

The question “who counts?” is at the heart of my global surgery work. For all our scientific and technological progress, we still lack basic health information – who dies and what from, who needs surgery and who receives it - for the majority of people living in low- and middle- income countries. Within Canada, the absence of key demographic and socioeconomic information in our health data conceals important and addressable variation in surgical access and outcomes for individuals and communities. 

Our global surgery research program focuses on quantifying the global burden of surgical conditions, understanding their health and economic impacts, and strengthening national health systems so that countries can better meet the surgical needs of their populations. This includes running large scale population-based prospective cohort studies, such as India’s Million Death Study, hospital-based registries with linked biobanking in Nigeria, and the GlobalSurg studies which run in more than 90 countries. The results are then used to design pragmatic trials of system-level interventions. Within Ontario, we are using similar methods to understand inequities in access to cancer screening, diagnosis and treatment, and to evaluate intervention bundles.  

The evidence generated is used to inform decisions for how best to plan for, finance and deliver surgical services. Our goal is to increase access to surgical care and improve outcomes for those most in need across the health system, within Canada and internationally. We work at multiple levels to do this: with patients, communities, surgical providers, hospitals, universities, Ministries of Health, NGOs and multilateral agencies (e.g WHO, World Bank). To ensure sustainability, we are training the next generation of health system researchers, thinkers and leaders through programs such as our Princess Margaret Global Oncology Leadership Development course and our Temerty-Ukraine National Health Leadership program.