Introduction

Global surgery, despite its critical importance, often remains in the shadows of global health initiatives.
This is particularly evident in South Asia, where the world’s largest population lacking access to essential surgery resides.

Why discuss this?

Global surgery aims to address this disparity by focusing on equitable access to emergency and essential surgical care, encompassing a range of procedures.
While 2015 marked a turning point in recognizing the significance of global surgery, this field’s history goes back several decades.

Equitable Access: Global surgery prioritizes providing equitable access to emergency and essential surgical care, predominantly in low- and middle-income countries (LMICs), but also in under-served populations within high-income countries (HICs).
Scope of Surgery: It encompasses essential and emergency surgeries, including surgery, obstetrics, trauma, and anaesthesia (SOTA).

Annus Mirabilis of 2015: This year marked a pivotal moment in recognizing the global significance of surgical care.
Influential Reports: The Disease Control Priorities Network (DCPN) report sponsored by the World Bank and The Lancet Commission on Global Surgery (LCoGS) played key roles.
WHO Resolution 68.15: The World Health Organization Declaration on Safe Surgery highlighted the essential role of surgical systems in achieving universal health coverage.

Access Disparities: Over 70% of the global population, around five billion people, lack timely access to safe and affordable surgical care.
Regional Disparities: Access gaps are most severe in low- and lower-middle-income countries (LLMICs), with 99% and 96% of people facing disparities, compared to 24% in HICs.
South Asia’s Challenge: Over 1.6 billion people, over 98% of South Asia’s population, lack access to safe and affordable SOTA care.
Disease Burden: In 2010, surgically treatable conditions caused around 17 million deaths, surpassing the combined mortality burden of HIV/AIDS, tuberculosis, and malaria.
Economic Impact: The cumulative projected loss to global GDP due to insufficient surgical care could reach $20.7 trillion by 2030.

Neglect in Policies: Surgical care often receives little attention in international and national policies.
Limited Research Focus: Research in global surgery is underrepresented compared to global health.
Funding Neglect: Funding for surgery is significantly lower than for other health sectors.
Research Funding Disparity: Research funding for surgery-related projects is scarce compared to other health fields.

Cost-Effectiveness: Global surgery has demonstrated that emergency and essential surgical care is cost-effective and cost-beneficial.
Policy Commitment: Many countries have initiated National Surgical, Obstetrics, and Anaesthesia Plans (NSOAPs), demonstrating political and policy commitment.
Positive Initiatives: Several South Asian countries have launched initiatives to expand surgical access.
Research and Innovation: Prioritizing research, policy support, and sustainable financing are key to addressing global surgery challenges.