PT  - JOURNAL ARTICLE
AU  - Mark Skopec
AU  - Alessandra Grillo
AU  - Alvena Kureshi
AU  - Yasser Bhatti
AU  - Matthew Harris
TI  - Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair
AID  - 10.1136/bmjinnov-2020-000535
DP  - 2021 Apr 01
TA  - BMJ Innovations
PG  - 482--490
VI  - 7
IP  - 2
4099  - http://innovations.bmj.com/content/7/2/482.short
4100  - http://innovations.bmj.com/content/7/2/482.full
SO  - BMJ Innov2021 Apr 01; 7
AB  - With over two decades of evidence available including from randomised clinical trials, we explore whether the use of low-cost mosquito net mesh for inguinal hernia repair, common practice only in low-income and middle-income countries, represents a double standard in surgical care. We explore the clinical evidence, biomechanical properties and sterilisation requirements for mosquito net mesh for hernia repair and discuss the rationale for its use routinely in all settings, including in high-income settings. Considering that mosquito net mesh is as effective and safe as commercial mesh, and also with features that more closely resemble normal abdominal wall tissue, there is a strong case for its use in all settings, not just low-income and middle-income countries. In the healthcare sector specifically, either innovations should be acceptable for all contexts, or none at all. If such a double standard exists and worse, persists, it raises serious questions about the ethics of promoting healthcare innovations in some but not all contexts in terms of risks to health outcomes, equitable access, and barriers to learning.All data relevant to the study are included in the article.