The burden of surgical conditions and access to surgical care in low- and middle-income countries

TLDR

Surgery is a vital yet underprioritized component of health systems, despite evidence of its cost‑effectiveness and a rapidly growing burden of treatable disease in low‑ and middle‑income countries, highlighting significant knowledge gaps. The study seeks to quantify the burden and distribution of surgical conditions, identify unmet surgical needs, assess required resources, evaluate potential health‑disparity impacts, and explore integration of essential surgical services into health system surveillance. The authors outline a research agenda and argue that sufficient evidence already exists to justify accelerated action to improve surgical care access.

Abstract

Surgery is an essential component of health systems but has generally been neglected within global public health. This is despite growing evidence documenting the cost-effectiveness of essential surgical care in low- and middle-income countries (LMICs).1 The overall burden of disease that may be cured, palliated or treated with surgical intervention is large and (probably) rapidly growing, and this concept must therefore be revisited. There are major gaps in knowledge related to surgery in LMICs. What exactly is the burden and distribution of surgical conditions in LMICs? What is the unmet surgical need? What resources (human, financial, physical) are required to improve access to surgical care? What impact would this have on global health disparities, and how does this compare with other interventions? How can essential surgical services be integrated into health systems’ surveillance and evaluation? This paper outlines a research agenda and argues that enough is already known to justify accelerated action.