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I was honoured to participate in the ACOI (Italian Association of Surgeons) Forum Next 2026, an important multidisciplinary event bringing together surgeons, clinicians, researchers, engineers and healthcare innovators to discuss some of the most pressing challenges and opportunities facing modern healthcare.

My participation followed a kind invitation from Dr Stefano Cappato, who considered my long-standing work in the fields of frugal innovation, healthcare sustainability and global health technologies particularly relevant to the Forum's discussions on Global Surgery and equitable access to healthcare.

The day opened with a remarkable panel dedicated to Global Surgery and international cooperation, featuring representatives from some of the world's leading humanitarian and global health organisations, including Daniela Picco (MSC Foundation), Elda Baggio (Médecins Sans Frontières), Marco Garatti (Emergency), Fabio Manenti (CUAMM), Andi Nganso (AMREF), Francesco Santoro (Fondazione Gaslini) and Fabio Massimo Abenavoli (Emergenza Sorrisi).

Listening to professionals who have spent years working on the front line of healthcare delivery across low-resource settings was both inspiring and thought-provoking. Many of the themes discussed during the panel resonated strongly with the research questions we have been exploring for years through our work in biomedical engineering: understanding local contexts, responding to real clinical needs, building sustainable healthcare solutions and ensuring equitable access to care. Their experiences reinforced a principle that has long guided our research: meaningful innovation does not start from technology, but from a deep understanding of people, workflows, healthcare systems and the environments in which solutions are expected to operate.

Against this backdrop, I had the pleasure of taking part in a live television interview on Frugal Innovation for Global Health, hosted by journalist Roberto Rasia and broadcast on Telenord. The conversation explored how biomedical engineering can contribute to addressing global healthcare challenges and how lessons learned from resource-constrained environments can help create more sustainable and resilient healthcare systems everywhere.

Drawing on almost a decade of research and field studies conducted across several countries in Sub-Saharan Africa and other resource-constrained settings, I discussed how healthcare technologies can be designed, evaluated and implemented more effectively through approaches that are fundamentally context-driven and user-driven.

Together with Prof. Leandro Pecchia, much of our work has focused on understanding healthcare environments before proposing technological solutions. This includes analysing healthcare systems and hospital infrastructures, studying the needs of patients and healthcare professionals, and translating those insights into practical design requirements.

The discussion covered methodologies for healthcare system assessment, hospital context analysis, reverse engineering of existing technologies and the development of frameworks that support the creation of healthcare solutions capable of delivering meaningful impact despite constraints in infrastructure, resources and specialist personnel.

A major theme of the interview was the growing importance of frugal innovation and sustainability in healthcare. While these concepts are often associated with low- and middle-income countries, many of the underlying principles are increasingly relevant to healthcare systems in high-income settings as well. Rising costs, workforce pressures and environmental concerns are forcing healthcare organisations around the world to rethink how technologies are designed, procured and implemented.

In many respects, the COVID-19 pandemic demonstrated that even the most advanced healthcare systems can benefit from approaches centred on resilience, adaptability, efficiency and responsible use of resources. What is often described as innovation for low-resource settings increasingly represents innovation for healthcare globally.

The discussion also touched upon our work on the development of frameworks for medical device design, methodologies for healthcare system assessment and technologies for diagnosis, monitoring and treatment support. These contributions have emerged from years of international collaboration and field-based research aimed at making healthcare technologies more accessible, appropriate and sustainable.

Beyond the discussion on frugal innovation and global health, the Forum provided an excellent opportunity to advance another important research initiative currently being developed with clinical and engineering partners.

Together with Leonardo Buratti, a talented intern from the ABSPIE Lab, we attended the Forum to further progress an ongoing early Health Technology Assessment (eHTA) project focused on an AI-enabled technology for the detection and assessment of intraoperative stress in surgeons.

The project seeks to evaluate the potential clinical, organisational, economic and societal implications of introducing this technology into routine surgical practice. The event offered a valuable opportunity to engage directly with members of the surgical community and strengthen discussions with ACOI regarding future collaboration around the project. These interactions will help shape future stakeholder engagement activities and focus groups aimed at assessing the real-world value and implementation challenges of this emerging technology.

As I noted during the event:

"One of the strongest messages emerging from the Forum was the importance of human-centred innovation. Whether we are discussing frugal technologies for global health or AI-based tools designed to support surgeons, innovation only creates meaningful impact when it starts from a deep understanding of users, clinical needs and context. It was a privilege to discuss these topics directly with leading members of the surgical community."

Leonardo played an important role in presenting the project and engaging with potential collaborators and stakeholders.

"Participating in the Forum was a unique opportunity to discuss an emerging healthcare technology with clinicians, researchers and healthcare leaders. The conversations reinforced how important it is to assess AI technologies not only from a technical perspective, but also in terms of their clinical usefulness, impact on wellbeing and integration into everyday practice."

It was also a pleasure to attend the Forum alongside my colleagues Prof. Arti Ahluwalia and Prof. Carmelo De Maria, whose expertise and longstanding contributions to biomedical engineering and healthcare innovation further enriched the discussions throughout the event.

My sincere thanks to Dr Stefano Cappato, ACOI, Roberto Rasia, Telenord, the distinguished panellists, speakers, organisers and participants for the invitation, the stimulating discussions and the opportunity to contribute to important conversations on the future of surgery, healthcare technology and global health.

Innovation becomes truly transformative when it is designed with people, context and sustainability at its core.