There are meetings that end with a stack of photos and slides, and there are meetings that feel as though they have moved a country one step closer to preserving limbs and lives. The 2026 VASSA Congress in Gqeberha was emphatically the latter.
More than a congress
Held at the Boardwalk Convention Centre from August 21–23, this national gathering brought vascular specialists, podiatrists, infectious disease physicians, endocrinologists, nurses and the broader diabetic-foot community together around a shared problem: how to turn good evidence into coordinated, locally workable action. I was honored to take part as one of four international keynote speakers (and lifelong friends) and even more honored by what was being built alongside the lectures.
The scientific program ranged across vascular disease, infection, microbiology, wound care, revascularization, and limb preservation. But the meeting’s center of gravity was larger than any one session. The official VASSA calendar named diabetic foot disease consensus as the congress theme, and that commitment could be felt throughout the meeting.
Prof Asha Malan, VASSA President for 2026–2027 and the society’s first woman to hold that office, helped set the tone as one of the congress hosts. This was locally led work: South African clinicians defining South African priorities, while drawing on international experience where it could be useful.
Four keynotes—and decades of friendship
One of the great pleasures of the meeting was sharing the international keynote roster with three people whose work—and friendship—have shaped my own journey.
Joe Mills, my former partner, “Flomigo Prime” and longtime friend, served as President of the Society for Vascular Surgery in 2023–2024. Joe’s work on the SVS WIfI classification and limb-threat assessment has changed the language of limb salvage around the world. We spent formative years together in Arizona helping build the Southern Arizona Limb Salvage Alliance, and it was wonderful to stand beside him again in Gqeberha.
Prof Zulfiqarali G. Abbas came from Dar es Salaam, Tanzania. Abbas is a longtime friend, an extraordinary diabetic-foot leader, and a founder member of the Step by Step Foot Project, launched in Tanzania in 2003 and subsequently carried to countries around the world. His career is a reminder that durable change begins not with a slogan, but with training, clinics, teams, and repetition.
Prof Rob Fitridge, another longtime friend and colleague, joined us from Adelaide. Rob is Professor of Vascular Surgery at Adelaide University and a consultant vascular surgeon in the Central Adelaide Local Health Network. His experience developing and implementing diabetic-foot and vascular guidelines made him an especially valuable voice for a meeting trying to connect evidence with a national system of care.
That combination—old friends, different disciplines, different continents, one shared purpose—gave the meeting a rare warmth. It felt less like a parade of experts and more like a working reunion.
Four steps toward a very large goal
My keynote, “Eliminating Preventable Amputation in South Africa and Worldwide: Four Steps to Success,” was delivered in Plenary Session 5 on infection and microbiology. The title carries a deliberately ambitious verb: eliminating.
Preventable amputation is not one problem. It is the downstream result of delayed recognition, fragmented referral, infection, ischemia, inadequate offloading, and health systems that too often make the right care difficult to reach. Success therefore requires teams and pathways—not heroics.
The most encouraging part of this congress was seeing that systems-level idea reflected back from the room. The vascular surgeon, podiatrist, endocrinologist, infectious-disease clinician, wound-care professional, nurse, orthotist, and rehabilitation team do not compete for ownership of the limb. They share responsibility for the person attached to it.
A first for South Africa
Alongside the congress, a locally led consensus process was developing what participants described as South Africa’s first country-specific diabetic-foot guidance. That is historic. International guidelines provide essential scaffolding, but guidance becomes useful only when it fits local referral pathways, workforce, resources, distances, and patterns of disease.
The distinction between consensus development and completed publication matters. This meeting was not the end of the process: local ratification, final wording, publication, dissemination, and implementation are the work that follows. But the first indispensable step was taken—the country’s own multidisciplinary community came together to build something it had not had before.
And the scale matters. South Africa stretches across roughly 1.2 million square kilometres—comparable in scale to several major Western European countries combined. Creating a shared approach across that geography is not a small administrative exercise. It is the beginning of a national clinical network.
Why this felt life-affirming
Guidelines can sound bloodless on paper. In practice, they are promises: that a person with a hot, swollen foot will be recognized earlier; that infection and ischemia will be treated with urgency; that referral will be clearer; that offloading will be available; and that where someone lives will become less predictive of whether that person keeps a limb.
That is why this meeting felt so life-affirming. The keynote was an honor. The friendships were a gift. But the most important part was watching a country decide that preventable amputation should not be accepted as inevitable.
The work ahead is enormous: consensus must become implementation, implementation must become measurement, and measurement must lead to improvement. Yet Gqeberha gave us something substantial to carry forward—a common language, a locally owned process, and a community willing to do the work together.
Related reading
References
- 2026 VASSA Congress official website and meeting dates
- 2026 VASSA Congress international keynote speakers
- Vascular Society of Southern Africa Executive Committee: Prof Asha Malan, President (2026–2027)
- World Federation of Vascular Societies: Women Presidents in Vascular Leadership
- Society for Vascular Surgery past presidents
- Adelaide University profile: Prof Rob Fitridge
- Abbas ZG et al. The Step by Step Diabetic Foot Project in Tanzania. International Wound Journal.
- South African Government: Geography and climate
Four keynotes came to Gqeberha from different corners of the world. The most powerful voice, however, was the shared one: South Africa can build a future with fewer preventable amputations—and it has begun.
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