3rd edition

Essential Surgery—identifi es 44 surgical procedures as essential on the basis that they address substantial needs, are cost eff ective, and are feasible to implement. This report summarises and critically assesses the volume’s fi ve key fi ndings. First, provision of essential surgical procedures would avert about 1·5 million deaths a year, or 6–7 % of all avertable deaths in low-income and middle-income countries. Second, essential surgical procedures rank among the most cost eff ective of all health interventions. The surgical platform of the fi rst-level hospital delivers 28 of the 44 essential procedures, making investment in this platform also highly cost eff ective. Third, measures to expand access to surgery, such as task sharing, have been shown to be safe and eff ective while countries make long-term investments in building surgical and anaesthesia workforces. Because emergency procedures constitute 23 of the 28 procedures provided at fi rst-level hospitals, expansion of access requires that such facilities be widely geographically diff used. Fourth, substantial disparities remain in the safety of surgical care, driven by high perioperati ve mortality rates including anaesthesia-related deaths in low-income and middle-income countries. Feasible measures, such as WHO’s Surgical Safety Checklist, have led to improvements in safety and quality. Fifth, the large burden of surgical disorders, cost-eff ectiveness of essential surgery, and strong public demand for surgical services suggest that universal coverage of essential surgery should be fi nanced early on the path to universal health coverage. We point to estimates that full coverage of the component of universal coverage of essential surger