The Diaspora's Contribution: A Theoretical Framework for Surgical Capacity Building in Gabon through Transnational Medical Expertise

This article proposes a theoretical framework for conceptualising the systematic engagement of Gabonese diaspora surgical professionals in strengthening domestic surgical capacity, a critical yet under-theorised component of health systems resilience in Central Africa. It addresses the persistent deficit in specialist surgical training and infrastructure in Gabon, contrasted with a substantial cohort of highly skilled Gabonese surgeons and anaesthetists practising abroad. Employing a rigorous desk-based methodology, the framework synthesises concepts from transnationalism, reverse innovation, and sustainable capacity building, analysing documented evidence from diaspora engagement initiatives (2021–2026) to construct its propositions. The core argument contends that structured, ethically governed transnational partnerships—moving decisively beyond ad hoc surgical missions—can catalyse sustainable local expertise through longitudinal mentorship, curriculum co-development, and telemedicine-facilitated supervision. This model explicitly prioritises the agency of African diaspora professionals as essential knowledge brokers who navigate dual health contexts to foster contextually relevant surgical ecosystems. The framework’s significance lies in offering a practical, Afrocentric pathway for health systems to leverage endogenous diaspora capital, contributing directly to Sustainable Development Goal 3 targets. It underscores a necessary policy shift for Gabonese institutions and regional bodies to formally integrate diaspora expertise into national surgical, obstetric, and anaesthesia plans, thereby transforming brain drain into a collaborative, sustainable brain gain for long-term health security.