Global surgical systems: progress, gaps, and priorities for the next decade

Abstract

Our new Lancet Health Policy analysis is the major comprehensive audit of surgical access since publication of the Lancet Commission on Global Surgery in 2015. These benchmarks should be viewed in context, since the severe constraints of the COVID-19 pandemic hampered progress. Without the efforts made so far, performance would have been even weaker. Low‑income countries still perform fewer than 1000 operations per 100,000 population each year, one fifth of the benchmark set ten years ago. Postoperative death remains a major unsolved problem, now estimated at more than three million deaths annually, exceeding deaths from tuberculosis, malaria, andH IV/AIDS combined. These figures should continue to force the global surgery community to rethink how it frames value, measures progress, and persuades governments to invest.