Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4…

Adil Haider, John W. Scott, Colin D. Gause, Mira Meheš, Grace Hsiung, Albulena Prelvukaj, Dana Yanocha, Lauren M. Baumann, Faheem Ahmed, Na’eem Ahmed, Sara Anderson, Herve Angate, Lisa Arfaa, Horacio Asbun, Tigistu Ashengo, Kisembo Asuman, Ruben Ayala, Stephen Bickler, Saul Billingsley, Peter Bird, Matthijs Botman, Marilyn Butler, Jo Buyske, Angelo Capozzi, Kathleen Casey, Charles Clayton, James Cobey, Michael Cotton, Dan Deckelbaum, Miliard Derbew, Catherine deVries, Jeanne Dillner, Max Downham, Natalie Draisin, David Echinard, Sohier Elneil, Ahmed ElSayed, Abigail Estelle, Allen Finley, Erica Frenkel, Philip K. Frykman, Florin Gheorghe, Julian Gore‐Booth, Richard Henker, Jaymie Henry, Orion Henry, Laura Hoemeke, David Hoffman, Iko Ibanga, Eric V. Jackson, Pankaj Jani, Walter Johnson, Andrew Jones, Zeina Kassem, Asuman Kisembo, Abbey Kocan, Sanjay Krishnaswami, Robert Lane, Asad Latif, Barbara Levy, Dimitrios Linos, Peter Linz, Louis A. Listwa, Declan Magee, Emmanuel Makasa, Michael L. Marin, Claude Martin, Kelly McQueen, Jamie Morgan, Richard Moser, Robert Neighbor, William M. Novick, Stephen Ogendo, Akinyinka Omigbodun, Bisola Onajin‐Obembe, Neil Parsan, Beverly K. Philip, Raymond Price, Shahnawaz Rasheed, Marjorie Ratel, Cheri Reynolds, Steven M. Roser, Jackie Rowles, Lubna Samad, John Sampson, Harshadkumar Sanghvi, Marchelle L. Sellers, David Sigalet, Bruce C. Steffes, Erin Stieber, Mamta Swaroop, John Tarpley, Asha Varghese, Julie Varughese, Richard Wagner, Benjamin Warf, Neil Wetzig, Susan Williamson, Joshua Wood, Anne Zeidan, Lewis Zirkle, Brendan Allen, Fizan Abdullah

After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.