From weakness to hope
To translate political commitments into tangible public health programmes that help all, World Health Organization has started developing National Surgical Obstetric and Anaesthesia Plans. Four countries in Sub-Saharan Africa have completed the development of their National Surgical Obstetrics and Anaesthesia Plan (Zambia, Ethiopia, Tanzania and Senegal) and many more (including Rwanda, Zimbabwe, Mozambique, Madagascar) are on the road to achieving this. These plans should, besides addressing the huge burden of neglected surgical disease, also help these countries address other public health challenges and commitments, including the Sustainable Development Goals.
Improved surgical care would strengthen the health system at the primary level and is one of the practical means of ensuring universal health coverage in a nation, but safe surgical care cannot be provided without complementary improvements in laboratory and imaging services, blood transfusions and referral services. Improving surgical care capacity will also need improvements in health financing, increased availability of essential medicines, a better health information management system that includes surgery, and better health systems governance. After the Ebola disease outbreak in West Africa in 2014, “weak health systems” were identified as the key factor in the wide spreading and difficult control of the virus.