Recognizes that the failure to appreciate the role of surgery in addressing important public health problems is the main cause of disparities in surgical care worldwide. Confusion persists about what constitutes surgical care and the role surgery should have in settings of limited resources. First-level hospitals in low- and middle-income countries (LMICs) provide the bulk of their emergency care and therefore deal with many surgical life-threatening injuries as well as catastrophic conditions. Scaling up basic surgical care in LMICs could prevent 1.4 million deaths and 77.2 million disability-adjusted life years (DALYs) per year. Some common conditions like cataracts, clefts, congenital heart anomalies, and obstetric fistulas can benefit from subspecialty surgical care and result in prevention of 388,000 deaths and avert 38.9 million DALYs per year. The challenge for surgery is to integrate the organizational structure of surgical care into the larger health system and to concurrently develop methods for measuring its performance.


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