Background on Global Surgery
There are currently gross disparities in access to safe, essential surgical care worldwide, and an alarming lack of global focus on widespread provision of quality surgical services. Modest estimates show that billions of people worldwide lack access even to basic surgical care. Out of the roughly 250 million operations performed each year, only 3,5% are performed on the poorest 1/3 of the world’s population. Another low estimate holds that 11-15 % of the world’s disability is due to surgically treatable conditions. Injuries alone cause 5.7 million deaths yearly, much more than the 3.8 million deaths caused by malaria, HIV/AIDS and tuberculosis taken together.
Other prominent conditions that demand surgical treatment are cancer, congenital anomalies such as club foot and cleft lip, cataract and obstetric complications. Surgery has a crucial role to play in achieving universal health coverage including the United Nations Millenium Development Goals, a set of goals set by the UN in 2000 to be fulfilled by 2015. Lack of treatment puts a significant economic burden on the millions that cannot work or function due to conditions for which the treatment has been known for decades.
Surgical treatment has been identified as a cost effective intervention in resource-poor settings, in level with vaccination programs 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.
Various solutions have been suggested to address the lack of surgery for a vast part of the global population:
- Training more surgeons and trying to incentivize them to stay in underserved regions
- Surgical missions
- Strengthening national health systems through sustainable, global partnerships between surgeons, hospitals and institutions
The goal is to achieve an equitable distribution of treatment options, and to integrate different aspects of health care, from prevention and primary care to antibiotics and surgery. Interest in this endeavor is growing among researchers, clinicians, politicians, trainees and students in all parts of the world.
Purpose of the Commission on Global Surgery
There is an overall paucity of political support, financial resource allocation and policy mechanisms to create equitable and scalable surgical systems worldwide. The purpose of this Lancet Commission is to address this need through a health systems strengthening framework and to embed essential surgical care within the global health and development agenda. The Commission will be supported by an international secretariat, and will engage a multi-disciplinary collaboration of experts and decision-makers (Commissioners) from around the world, who will convene for a series of three structured meetings.
There are five key objectives for the Commission
- Examine the current state of surgery within the global health agenda.
- Characterise the role, nature and spectrum of essential surgery within functional health care systems in LMICs.
- Identify critical health systems barriers that prevent universal access to safe, high quality surgical care in LMICs.
- Define scalable priority actions that must be taken to overcome these barriers
- Define the roles of governments, international bodies, academic institutions, surgical colleges, NGOs, health funders, health care providers and local communities in the attainment of these goals.
The Commission will culminate in the publication of a 25,000 word report that will provide a tangible reference point for governments, policy-makers, international bodies, funding agencies, academic institutions, professional colleges, healthcare providers and local communities to engage in concrete action. The key findings and priority actions will facilitate the development, implementation and evaluation of surgical policy to promote the delivery of surgical services worldwide.
Additional Information and Translated Overviews
Please review our General Introduction document for additional information regarding the goals, preliminary plans and current timeline for the Commission.