What is global surgery?
Global surgery focuses on equitable
access to emergency and essential
surgery. While it predominantly focuses
on low and middleincome countries
(LMICs), it also prioritises access
disparities and underserved populations
in highincome countries (HICs). These
“surgeries” include essential and
emergency surgeries such as surgery,
obstetrics, trauma, and anaesthesia
(SOTA). Despite small differences, there is
largely a consensus across multiple
international groups on about thirty
procedures that fall under the umbrella of
emergency and essential surgery.
How far back does global surgery go?
The year 2015, can be considered the
“Annus Mirabilis” or the miracle year for
global surgery. It proved to be an
inflection point in recognising the
importance of surgical care on a global
scale. One key development that played a
significant role in this transformation was
the Disease Control Priorities Network
(DCPN) report on essential surgery
sponsored by the World Bank which
highlighted that emergency and essential
surgical care is costeffective; scaling up
surgical systems is costbeneficial; and
that there is a large disease burden that is
surgically avertable.
The second development was The
Lancet Commission on Global Surgery
(LCoGS) which brought together experts
and stakeholders to examine the status of
surgical care access around the world;
ideate the indicators for monitoring
surgical care preparedness; systemic
capacity and impact; and to develop
implementable strategies such as the
national surgical, obstetrics, and
anaesthesia plan (NSOAP). This paved the
way for arguably the most important
highlevel policy and political
commitment to surgery, which is the
passage of the World Health Organization
Declaration on Safe Surgery (WHO
Resolution 68.15) which recognised the
impossibility of universal health coverage
in the absence of required commitment to
emergency and essential surgical systems.
While 2015 set the stage for popular
global surgery, it is critical to note that the
history of the field as a whole goes back
several decades. The exchange of
knowledge and bilateral sharing of
trainees under surgical missions in
humanitarian settings across various parts
of the world in the last century can be
considered global. Given the focus on
reducing disparities, people have also
rightly argued that surgeons committed to
delivering care in rural and remote parts
of the world found global surgery several
decades before 2015.