surgeons Christopher Furlong/Getty Images

Surgery for All

Five billion people worldwide lack access to safe, affordable surgical and anesthetic care. But improving access to surgery when needed would not only be good for people’s health; it is also one of the best ways to boost economic productivity in low- and middle-income countries.

BOSTON – On a recent trip to India, I hailed a rickshaw that was pedaled, I soon noticed, by a man with a lame leg. It turns out that a few weeks earlier, the driver had been hit by a car while navigating the busy streets of New Delhi. Although he had managed to obtain medication from a local pharmacy for the agonizing pain – probably because his leg was broken – he could spare neither the time nor the money to see a surgeon.

This type of tragic calculus is strikingly common. The Lancet Commission on Global Surgery estimates that some five billion people – almost 70% of the world’s population – lack access to safe, affordable surgical and anesthetic care, while 33 million people are saddled with unbearably high health expenses. Not surprisingly, the global poor suffer disproportionately: while low-income countries are home to close to 35% of humanity, they account for just 3.5% of all surgical procedures.

One of the biggest obstacles to achieving universal health coverage – which the United Nations has declared a global goal – is financing. And, paradoxical as it may sound, one of the best ways that governments can get the money they need to expand coverage is by making surgery more widely available.

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