Global Surgery: advent of a new discipline

Global surgery is a rapidly developing multidisciplinary field, aiming to provide equitable and improved surgical care across international health systems often with a focus on underserved populations of low- and middle-income countries1. History is witness that Christian Missionaries, International Committee of the Red Cross, Aga Khan Foundation and Islamic Association of North America have been offering humanitarian health support, including Surgery, to the needy since long. These were joined by League of Nations Health Organization (since 1920; later became the World Health Organization in 1946) and Médecins Sans Frontières (since 1971)2. However, Surgery remained ‘The neglected stepchild of global health’3. Main reason for this was lack of data leading to knowledge gap about the magnitude of the problem. The much needed catalyst for development of Global Surgery was the launch of Lancet Commission on Global Surgery report in January 20144. This report provided the much needed data about unmet needs of Surgery which grabbed the World’s attention: 5 billion people not having access to safe, timely affordable surgery and anaesthesia; leading to 18.6 million preventable early deaths each year - more than the number of people who die from HIV/AIDS, malaria and tuberculosis combined; millions of patients facing catastrophic expenditures when faced with surgical costs and many low- and middle-income countries likely to lose up to 2% of GDP due to loss of proper surgical care leading to loss of productivity. They also predicted that to reach the necessary levels of access to surgery by 2030 would require an investment of $420 billion, which would save an estimated $12 trillion in lost GDP over the same period, making it a very sound investment. And global burden of surgical disease was estimated to be ~ 30%5.