Tuesday, 5th July 2011: COST-Africa is launched in Malawi
The launch and first international workshop of COST-Africa took place on Tuesday, 5th July 2011 at the Queen Elizabeth Central Hospital, Blantyre, Malawi. This five year collaboration (2011-2015), which will evaluate surgical training of Clinical Officers in Africa, is funded by the European Union under its FP7 and is led by Professor Ruairí Brugha, Head of Epidemiology and Public Health Medicine at RCSI. The four-country collaboration includes two African and two European institutions: College of Medicine Malawi (CoM), Surgical Society of Zambia (SSZ), University of Nijimegen Netherlands and RCSI.
African countries have surgeons trained to top international standards, but far too few to tackle the burden of disease that is amenable to surgery, especially in rural areas. Cost Africa will train clinical officers, who are the backbone of clinical care in rural Africa, to undertake life-saving emergency and elective major surgery at district hospitals in Malawi and Zambia. The rationale is that, unlike doctors and nurses, clinical officers’ qualifications and training have no counter-part in Europe or the US, making emigration from Africa difficult for them.
The investigators will use a cluster randomised controlled trial study design to provide proof-of-concept that surgery can be delivered cost-effectively and safely in district hospitals in Africa. Roll out of lessons learned to other African countries will be through the College of Surgeons of East, Central and Southern Africa (COSECSA) whose members span 9 African countries.
African countries have surgeons trained to top international standards, but far too few to tackle the burden of disease that is amenable to surgery, especially in rural areas. Cost Africa will train clinical officers, who are the backbone of clinical care in rural Africa, to undertake life-saving emergency and elective major surgery at district hospitals in Malawi and Zambia. The rationale is that, unlike doctors and nurses, clinical officers’ qualifications and training have no counter-part in Europe or the US, making emigration from Africa difficult for them.
The investigators will use a cluster randomised controlled trial study design to provide proof-of-concept that surgery can be delivered cost-effectively and safely in district hospitals in Africa. Roll out of lessons learned to other African countries will be through the College of Surgeons of East, Central and Southern Africa (COSECSA) whose members span 9 African countries.
Direct benefits to Africa
COST-Africa will bring direct life-saving and other health benefits to the people of Malawi and Zambia, especially rural dwellers who lack easy access to urban centres and whose only hope of life-saving emergency surgery is if it can be delivered at the nearest district hospital. The outcome will be a fully tested model that will:
COST-Africa will bring direct life-saving and other health benefits to the people of Malawi and Zambia, especially rural dwellers who lack easy access to urban centres and whose only hope of life-saving emergency surgery is if it can be delivered at the nearest district hospital. The outcome will be a fully tested model that will:
- a.) Make a major and sustainable impact on Africa’s Burden of Disease.
- b.) Provide African countries with surgically trained, sustainable and retainable health professionals.
- c.) Demonstrate the potential of a 3-fold role to help retain Africa’s scarce resource of highly trained surgeons – as specialists, trainers (of doctors and clinical officers); supervisors and quality assurers of surgical services.

Among the participants, in the back row (left to right) are; Dr. Juzer Lotya (RCSI), Prof. Ruairi Brugha (RCSI), Dr. Douglas Komani Lungu, Gerald Mwapasa (CoM). The middle row, left to right, includes; Dr. Elaine Byrne (RCSI), Prof. Mohamed Labib (SSZ), Dr. W. Mulwafu, Dr. Robert Zulu (SSZ), Dr. Welani Chilengwe, Prof Eric Borgstein (CoM). The front row, left to right includes; Dr. Tracey Mc Cauley (RCSI), Dr. Victor Mwapasa (CoM), Dr. Mary Zulu, Edward Chibwili (SSZ), Maureen Chirwa (CoM), Dr. John Kachimba (SSZ), Laura Phelan (RCSI).