Implementing Sustainable Development Goal on Education (SDG4) amid Donor Fatigue: Challenges for the Global South

This paper critically reflects on the implementation of the Sustainable Development Goal on education (SDG4) in the Global South amid apparent donor fatigue. It also highlights international observers’ concerns about a huge funding gap in the implementation of SDG4 in the Global South. With the COVID-19 pandemic currently ravaging the world, this funding gap will only widen. In the face of these challenges, low-income countries with a high dependency on aid remain at risk of defaulting on most SDG4 targets. While reflecting on what the decline in education aid might mean for low-income countries, the paper argues that a truly transformative approach can help these countries achieve SDG4 and its sustainability agenda despite funding challenges.

EP.FRI.992 Milking the COW: A pilot study of seven-day consultant working

Aims The Five Year Forward View, predicts a funding gap of nearly £30 billion per year by 2020/21, with continued disparity in resources and healthcare demand. Further, the view describes ever widening gaps in three main domains of healthcare; prevention, quality and efficiency. Those domains raised are echoed in the efficient operative working of a general surgical service with an aged, co-morbid population and inefficient theatre utilisation with increasing case cancellation due to lack of bed space. In 2012, the Academy of Medical Royal Colleges recommended patients have the same standard of care seven days a week, with consultant review ‘at least once every twenty-four hours’. In general surgery, will a seven-day consultant led working model with a ‘consultant of the week’ (COW) enable more rapid and appropriate decisions to be made for patients enabling their efficient treatment and reducing length of stay. Method A retrospective analysis of hospital length of stay and mortality before and after the implementation of a consultant led weekday and weekend service in general surgery was carried out looking at data in October 2017 and 2018. Results The introduction of enhanced seven-day working is associated with reductions of one fifth in length of stay but no difference in mortality. Conclusions Whilst statistically significant associations with the COW and reduced length of stay have been made, the clinical significance of one fifth of a day may be negligible. Continued data collection over a longer time period, prospectively will increase the power of the study.

Racial inequity in grant funding from the US National Institutes of Health

Biomedical science and federal funding for scientific research are not immune to the systemic racism that pervades American society. A groundbreaking analysis of NIH grant success revealed in 2011 that grant applications submitted to the National Institutes of Health in the US by African-American or Black Principal Investigators (PIs) are less likely to be funded than applications submitted by white PIs, and efforts to narrow this funding gap have not been successful. A follow-up study in 2019 showed that this has not changed. Here, we review those original reports, as well as the response of the NIH to these issues, which we argue has been inadequate. We also make recommendations on how the NIH can address racial disparities in grant funding and call on scientists to advocate for equity in federal grant funding.