ABSTRACT
Nascent health systems in many low-and middle-income countries (LMICs) are now beginning to grapple more formally with their burden of surgical disease. For several decades, surgery has taken a back seat to the challenges of human immunodeficiency virus (HIV) and malaria. Surgical disease is generally underfunded and has not to date received the energy and attention of the acquired immunodeficiency syndrome (AIDS) epidemic. When the HIV epidemic began, few considered that surgeons would look to the relative success of HIV funding, antiretroviral treatment, and public health programs as a model for noncommunicable disease. Emergency response systems, prompt diagnostic interventions, surgical access, safe anesthesia, postoperative care, and the many support services such as pathology and radiology are all components of effective surgical care. The systematic development of these essential components poses challenges and opportunity for surgical stakeholders.
