The emergence of surgery as a major force in the public health arena

Abstract

Surgery has hitherto never been considered seriously in matters of public health as it is seen as being reliant upon highly trained personnel and expensive infrastructure. Moreover, the general perception of global health programs has been as ideally community based, with emphasis on communicable diseases, nutrition, hygiene and prevention. Surgery has unfairly been seen as elitist, adhocist, demandbased and beneficial to individuals, not populations. However, with the publication of the World Bank’s Disease Control Priorities, 3rd Edition (DCP3), the immense scope and potential of surgical intervention in dealing with the global disease load is widely becoming apparent. Also, newer quality-of-life parameters are proving beyond doubt that the benefit-cost ratios of surgical interventions far exceed those of many conventional public health measures. This paper refutes some of the misconceptions surrounding the role of surgery in public health, and explores the key messages of DCP3. In conclusion, it suggests that the provision of essential and emergency surgical services be considered a benchmark for public health standards. There is a pressing need for surgeons themselves to reposition surgery in the global health scenario by advocating and implementing principles that project the discipline as a powerful tool in the worldwide campaign for human health.

Keywords: Surgery; Public health