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John Cairns
Introduced by Vice-Chancellor Professor Irene Tracey, the deeply personal lecture traced his journey from apartheid-era South Africa to Oxford, highlighted major findings from pan-African surgical research, and issued a call for global health equity
‘I believe I can do more for Africa in Oxford than I can do for Africa in Africa.
Professor Biccard structured his lecture in three parts - “a beginning, a middle and an end” - so, as he joked "you can choose which third you want to be awake for".
Beginning with a reflection on his upbringing in South Africa during apartheid and the influence of inequality, education and mentorship, he drew on the philosophy of ubuntu - “I am because we are” - emphasising the many collaborators who have contributed to his work.
The core of the lecture, which he outlined as being ‘for the nerds’, focused on safer surgery as a global health imperative. While modern anaesthesia has become remarkably safe, he argued, the key challenges now lie in maintaining safety for increasingly complex and ageing surgical populations, and in ensuring equitable access to safe surgery and anaesthesia worldwide.
Professor Biccard presented findings from the African Surgical Outcomes Study and subsequent collaborative research spanning more than 70,000 patients across 43 countries which revealed that around 50% of surgical mortality can be attributed not to the patient or procedure, but to the context - lack of resources and unsafe environments.
The lecture concluded with a series of ethical questions 'for the philosophers', about whether it is acceptable that health outcomes depend on geography, economics and politics and his belief that we all have a responsibility to contribute towards equity in our own way. He also urged universities to consider how they identify and support future clinician-scientists, suggesting that potential impact, particularly in under-resourced settings, must be valued alongside traditional academic merit.
Earlier in the lecture, Professor Biccard explained that his predominant reason for being here is because ‘I believe I can do more for Africa in Oxford than I can do for Africa in Africa.’ Accepting the Nuffield Chair, he pledged to honour the role, the profession, society and Africa.