Equity in Access to Safe Surgery and Anesthesia

In a recent review by Steffner et al., the authors present the currently available evidence regarding disparities in access to safe surgery and anesthesia.  They describe the growing burden of surgical disease in low- and middle-income countries, the major gaps in human resources, material supplies, and infrastructure, and the lack of data from which to approach these issues.  Together, these issues comprise a major source of inequity within global health.  Over two billion people around the world lack access to basic surgical services, yet billions more likely lack access to surgery that is safe, well-timed and effective.  Equity is an important consideration in global health and, as stated by Paul Farmer, “What branch of medicine or public health is not forced to confront the growing outcome gap that promises to shield the privileged, while the world’s bottom billion continue to die from readily preventable or treatable disease.” 

While there is obviously no quick fix to the inequity in the provision of surgery around the world, Steffner et al. go on to describe potential ways forward.  They advocate for bolstered research efforts, expanded support for ongoing surgical system strengthening initiatives, and increased advocacy by global leaders.  Operation Smile is committed to increasing equitable access to surgical care and believes that patient-centered surgical care delivery is essential to this goal.


Steffner KR, McQueen KA, Gelb AW. Patient safety challenges in low-income and middle-income countries. Curr Opin Anaesthesiol. 2014 Dec;27(6):623-9.

Farmer PE, Furin JJ, Katz JT. Global health equity. Lancet. 2004 May 29;363(9423):1832.


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