REIMAGINING SURGICAL CARE
African countries and experts have been at the forefront of efforts to improve surgical care in the continent, recognizing the critical importance of surgical care in achieving universal health coverage. According to the Lancet Commission on Global Surgery, approximately 93% of the population in LMICs lack access to safe, timely, and affordable surgical care, resulting in significant morbidity and mortality. In Africa, an estimated 93 million people require surgical care annually, yet only 5% of these receive it. In response to these significant gaps in surgical care, several African countries have developed and implemented national surgical plans and policies, including Ethiopia, Madagascar, Nigeria, Rwanda, Tanzania, Zambia, Republic of Zimbabwe and most recently Namibia just launched its national Surgery Obstetrics and Anaesthesia Strategy in November 2023.
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African experts have played an active role in shaping global policies and strategies to improve surgical care, including participating in the Global Surgery 2030 report, developed by the Lancet Commission on Global Surgery (LCoGS). The report highlighted the significant gaps in access to surgical care in LMICs, including in Africa. The report estimated that over 143 million additional surgical procedures would be needed in LMICs annually to meet the surgical needs of the population. Professor Emmanuel Ameh, a Nigerian surgeon, and Professor Emmanuel Makasa of the Republic of Zambia were members of the LCoGS, and have made significant contributions to the report and follow-up action to translate the LCoGS report from an academic document into a national health policy using the National Surgical Obstetric Anesthesia Planning (NSOAP) Framework. This played a critical role in the development of national healthcare policies in Zambia and now many other African Countries and helped raise awareness of the critical importance of surgical care in Africa.  ​
"In Africa, an estimated 93 million people require surgical care annually, yet only 5% of these receive it."
African experts have also been involved in developing global policies, guidelines, and recommendations for improving surgical care. The Republic of Zambia’s Prof. Emmanuel Makasa tabled and chaired intergovernmental negotiations that culminated in the adoption of the WHO resolution WHA68.15 on Strengthening Surgical Care and Anaesthesia as a component of Universal Health Coverage and the follow-up Decision WHA70(22). The African Surgical Outcomes Study (ASOS), led by a team of African researchers, provided insights into the outcomes of surgery in Africa and identified opportunities for improving surgical care. The ASOS study found that surgical patients in Africa had significantly higher mortality rates than in high-income countries and that many of these deaths were preventable. The study informed the development of the African Surgical Systems Collaborative, which aims to improve surgical care in Africa by promoting collaboration and sharing best practices among surgical providers in the continent.
While African countries and experts have made significant strides in improving surgical care, there is still much work to be done to address the significant gaps in access to safe, timely, and affordable surgical care in the continent. Continued investment and collaboration among African countries, experts, and global partners are needed to ensure that all Africans have access to the surgical care they need. This calls for the creation of an appropriate Africa-initiated and Africa-led multi-stakeholder platform for Africa where Member States working with their partners can begin to collaborate and coordinate Pan-African initiatives, share best practices, and learn lessons from each other. In addition, they can mobilize the needed resources for an Africa-wide response to addressing the ever-increasing surgical disease burden that has the potential to curtail the continents’ match towards good health and well-being, a requirement for sustainable development.