Bringing surgery in from the international cold

Millions of lives are being put at risk annually from unsafe surgery and there are gross disparities in access to essential surgical care worldwide – so reports the Lancet Commission on Global Surgery. Out of the roughly 250 million operations performed around the world, each year, only 3.5% are performed on the poorest one third of the world’s population. Another estimate reports that 11-15% of the world’s disability is due to surgically treatable conditions. A sharp rise in traumatic injuries and the prevalence of emerging cancers should also be able to be treated surgically and, in many low and middle income countries in the world, many people live more than two hours from a medical facility that can provide more than the very basic level of surgical care.

Surgical treatment has been identified as a cost effective intervention   in resourcepoor settings, in level with vaccination programmes and 10-15 times more so than antiretroviral medication for HIV. This is not to say that surgery is any more important than other types of treatment, but certainly as important as other global health priorities. The goal is to achieve an equitable distribution of treatment options, and to integrate different aspects of healthcare, from prevention and primary care to antibiotics and surgery.¹

Defining global surgery One of the key issues identified by the Commission is that it can be difficult to define surgery. It plays a part in many disease specific treatments but is not an entity on its own account. Jim Kim, president of the World Bank urged the global health community to challenge the injustice of global inequity in surgical care, stating that “surgery is an indivisible, indispensable part of healthcare and of progress towards universal health coverage.”