Surgical health policy 2025-35 – Bespoke solutions needed in lower and middle-income countries

The surgical health policy 2025-35 article is a comprehensive review of the lack of tangible progress of the 2015 Lancet Commission on Global Surgery’s 2030 targets1. Only 26% of Low-Middle-Income Countries (LMICs) are on track to meet the 2030 access target, 41% are on track for the workforce target, and none are on track for the surgical volume target1. These findings are not surprising as these targets were set for all countries, and with regard to access to surgery, the target was for all countries to provide at least 80% of the population with access to a facility providing the Bellwether procedures (emergency laparotomy, caesarean section and open fracture management) within a 2-hour travel by 20301. The enormity of the problem is underscored by Nigeria's finances: the second-largest economy in sub-Saharan Africa, with a total annual health budget of approximately $3 billion and an estimated $16.8 billion required over five years to implement a surgical plan1. These are the same problems faced by almost all low- and LMICs in achieving universal health coverage2.