Disease Control Priorities, Third Edition (Volume 1): Essential Surgery

Abstract

Essential Surgery is the first volume in the Disease Control Priorities, third edition (DCP3) series. DCP3 endeavors to inform program design and resource allocation at the global and country levels by providing a comprehensive review of the effectiveness, cost, and cost-effectiveness of priority health interventions. The volume presents data on the surgical burden of disease, disability, congenital anomalies, and trauma, along with health impact and economic analyses of procedures, platforms, and packages to improve care in settings with severe budget limitations. Essential Surgery identifies 44 surgical procedures that meet the following criteria: they address substantial needs, are cost effective, and are feasible to implement in low- and middle-income countries. If made universally available, the provision of these 44 procedures would avert 1.5 million deaths a year and rank among the most cost effective of all health interventions. Existing health care delivery structures can be leveraged to provide affordable and quality care, with first-level hospitals capable of delivering the majority of procedures, while addressing substantial disparities in safety. Existing infrastructure can also expand access to surgery by implementing measures such as task sharing, which has been shown to be safe and effective while countries build workforce capacity. Nearly ten years after the second iteration of Disease Control Priorities was released, increased attention to the importance of health systems in providing access to quality care is once again reshaping the global health landscape. Low- and middle-income countries are continuing to set priorities for funding and are making decisions across an increasingly complex set of policy and intervention choices with a greater appreciation for the value of program and economic evaluations. By reviewing the large burden of surgical disorders, the cost-effectiveness of surgical procedures, and the strong public demand for surgical services, Essential Surgery makes a compelling case for improving global access to surgical care.