Leveraging artificial intelligence to strengthen surgical systems in sub-Saharan Africa

This review discusses the potential of artificial intelligence (AI) to augment surgical care in sub-Saharan Africa (SSA), a region with significant surgical disparities. According to the Global Surgery 2030 initiative, SSA is disproportionately burdened by inadequate access to trained personnel, infrastructure, and economic resources, leading to preventable health outcomes. AI holds great potential throughout the surgical care pathway, from diagnosing and planning interventions via AI-based imaging and predictive algorithms to enabling more precise, minimally invasive procedures using AI-directed robotic platforms and navigation systems. AI can improve postoperative care via the remote monitoring of patients and AI-powered chatbots, which facilitate follow-up visits in low-resource settings. Surgical simulation and education will be reshaped with AI-enhanced virtual reality and AI-assisted web-based platforms, democratizing surgical knowledge. AI can strengthen health systems by more efficiently managing resource allocation, optimizing supply chain management, and analyzing health data. Practical examples exist, with case studies demonstrating successful AI implementations in these resource-constrained settings, including diagnostics, maternal health, and public health. However, the review highlighted several crucial challenges and concerns, including data availability and quality, infrastructure gaps, ethical implications (such as data protection and algorithmic bias), costs and affordability, and the need for robust regulatory frameworks. Targeted stakeholder recommendations highlight the need for investments in the related areas of infrastructure, data management, training, ethical guidelines, and regulatory frameworks. Thus, developing locally relevant datasets, affordable AI tools, additional ethical inquiries, and cost-effectiveness studies will be crucial. Through collective action and equitable implementation, AI can significantly enhance surgical care in SSA, leading to improved health outcomes.