All hands on deck to close the global surgery gap


As novel surgical techniques are being developed in the U.S. for rare and complex conditions, five billion people worldwide lack access to basic surgical care.

The Lancet Commission on Global Surgery detailed the enormous scope of this disparity in their landmark report, published in April 2015. The authors of the report found that 143 million additional surgeries are needed each year to save lives and prevent disability ― requiring a $350 billion global investment by 2030. But the case for action isn’t just humanitarian. Investing in surgery ― the neglected stepchild of global health ― would save developing countries approximately $12.3 trillion in lost GDP by 2030.

Two months after the report was published, the commission’s leaders ― along with ministries of health ― were already working on adding surgical indicators to the World Bank’s World Development Indicators, in order to better measure global surgery access moving forward. And just last week, the World Bank accepted four for their site:

  1. Number of surgical procedures,
  2. Density of specialist surgical providers,
  3. Risk of catastrophic expenditure for surgical care, and
  4. Risk of impoverishing expenditure for surgical care

“It’s amazing that the World Bank accepted our indicators,” says John G. Meara, MD, DMD, MBA, Plastic Surgeon-in-Chief at Boston Children’s Hospital and co-chair of the Lancet Commission on Global Surgery. “This will change the nature of global surgery and anesthesia research for the future. Now there is data that researchers can easily pull down and use for master’s and PhD theses.”

The hard-working commission presses on ― moving forward their agenda from a focus on analysis and measurement towards one of action. Earlier this month, Meara and his colleagues published a paper in BMJ Global Health, entitled, Global Surgery 2030: A Roadmap for High Income Country Actors. The paper challenges high-income countries to do their part in ending the access gap by 2030, stating they must “abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future.”

High-income countries must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future.

It outlines a series of actionable recommendations that universities, hospitals, surgeons, biotech companies, and the media in wealthy countries can take to help deliver surgical and anesthesia care to low- and middle-income countries (LMICs). “This report demonstrates a common policy agenda between major actors,” Meara says. “It provides a roadmap for maximizing benefit to surgical patients worldwide.”

Read the full paper in BMJ Global Health and an exclusive Q&A with John Meara.