GavinYamey says he and the other editors at wanted to make thecase that providing surgical services should be thought of as a global healthpriority. "We absolutely have to consider [surgery] as a building block ofglobal public health," he says, pointing to evidence that surgery?even inthe world's poorest countries?is feasible and cost-effective. "It can helpto lift people out of poverty," he adds.
The first reason for raising surgery'sprofile, Yamey says, is that medical conditions requiring surgery make up asubstantial proportion of the world's burden of disease. He also points outthat even though the developing world accounts for most of the demand forsurgical care, it receives the least. Providing that surgical care would boostnational health systems and primary care in general, he says, recalling aconversation he had with a surgeon who once worked in Africa. "When youprovide surgical services at a district general hospital in rural Africa, hisexperience is that it raises the overall quality of care at that hospital, andthat patients come to that hospital seeking attention for other non-surgicalconditions." He says it has a ripple effect, "when you providesurgery, people are more likely to attend for all sorts of otherconditions."
Theeditorial notes there are also economic reasons for bringing surgery back intothe global health conversation. Providing basic surgical services comparesfavorably, the article contends, with traditional programs like childhoodvaccinations. And non-doctors can be trained to provide some care, such asCaesarian sections, even in the most resource-poor areas.
Whilemost public health funding is now targeted at a single disease or a specificcampaign, Yamey says there is a compelling reason for shifting some of themoney to improve surgical capacity in developing countries: "Surgery couldhelp to reach the .
TheU.N. document is the blueprint that has been agreed upon by all the world'scountries and leading development institutions to meet the needs of the world'spoorest. "The Millennium Development Goals lay out a certain number oftargets that we hope we can meet," Yamey explains, "for example,reducing child mortality, improving maternal health, tackling infections. What'sfascinating, and we think pretty compelling, is that surgical services couldhelp in reaching many of these goals."
GavinYamey says he and his fellow editors are encouraged by the fact that surgeonsand public health professionals are coming together to build a movement topromote surgery as a crucial tool in improving global public health.
Theireditorial appears in the current issue of .