At a pivotal World Health Assembly (WHA) side event in Geneva, the non-governmental organizations Mercy Ships (MercyShips.org) and Operation Smile commemorated a decade of leadership in global efforts to enhance access to equitable surgical care. This event brought together global leaders, health ministers, and experts to celebrate progress, and confront the urgent challenges that remain in delivering safe, affordable surgical care to all.?

Despite growing awareness and political resolutions that have been adopted, 5 billion people still lack access to safe, affordable surgical care. (Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development - The Lancet) (https://apo-opa.co/4jK2VZL). This gap between commitment and reality was a central theme throughout the event held during the 78th WHA last Wednesday. 

Dr. Neema Kaseje, a pediatric humanitarian surgeon working in Kakuma Refugee Camp, emphasized the human stories behind those statistics: women in urgent need of lifesaving C-sections and children with congenital conditions kept from the opportunity of attending school. 

“We now know that 5 billion people lack access to surgery. But operationally, we are far behind. Access alone isn’t enough,” she added. “Poor-quality surgical services can worsen outcomes. We need to ensure access to high-quality care, especially in fragile and rural contexts.” 

Echoing that, Dr. Barnabas Alayande, General Surgeon and faculty member at the University of Global Health Equity in Rwanda said, “Even after training 2,500 surgeons since 2015, surgical workforce density has barely increased, just 0.06 per 100,000. At the current pace of workforce development, it could take 300 years to train enough surgeons to meet global demand. We need to start thinking creatively: leveraging technology like telementoring, hub-and-spoke models, and place-based education to improve rural retention. We must rethink who we train, where and how.” 

Political Commitment 

A highlight came from Hon. Kwabena Mintah Akandoh, Ghana’s Minister of Health, who delivered a powerful address, underscoring the nation’s commitment to equitable surgical care. Highlighting the September 2024 launch of Ghana’s National Surgical, Obstetric, and Anesthesia Plan (NSOAP), he framed access to surgical services as a matter of justice, not just health. 

The plan, aligned with Sustainable Development Goal 3, is built around six pillars, from infrastructure to financing. In less than a year, Ghana has assessed over 100 facilities for surgical facilities, trained more than 300 providers, and procured essential equipment.  

“Surgical indicators have been incorporated into Ghana’s national health information system (DHIMS), and the country is moving toward a 20% salary incentive for health workers in rural areas to improve retention,” he said.  

While Ghana demonstrates what is possible, other nations remain stalled. Dr. Emmanuel Makasa, a longtime advocate and orthopedic surgeon, emphasized that political will must translate into horizontal integration, not isolated or vertical programs.  

“Innovation is also essential. We need regional collaboration to produce critical surgical supplies such as sutures, blades, and IV fluids, so countries can support each other and reduce dependency. Sustainability comes not from rhetoric, but from action, integration, and innovation that is rooted in system-wide responsibility.”  

Building for the Future  

While the past decade focused heavily on data, indicators, definitions, and metrics, several speakers highlighted the need to now use that foundation to drive transformation.  

“The focus on metrics, definitions, and data collection has been foundational,” said Dr. Caroline Haylok-Loor, Anesthesiologist and President-elect of the World Federation of the Societies of Anesthesiologists (WFSA) council. “It gave us direction, tangible solutions backed by evidence from studies and systematic reviews. Now we are aware; there is clarity about the challenges and where we need to go.”  

Dr. Teri Reynolds, who leads Clinical Services in the department of Integrated Health System at the World Health Organization (WHO) highlighted how the movement has inspired a new generation of health professionals, surgeons and anesthesiologists who gained opportunities and experiences they wouldn’t have had without the pathways opened by the global surgery movement.  

Partnership as a Driving Force

A recurring theme of the evening was the power of partnership. Dr. Ayala issued a powerful call for multisectoral collaboration. Governments cannot do it alone. NGOs, foundations, and the private sector must work together, sharing expertise and learning, to transform partnerships into sustainable impact.  

Marina Anselme, Secretary General of the MSC Foundation, shared how industry and the private sector can play a supporting but vital role in strengthening health systems. “We support Mercy Ships and Operation Smile by transporting emergency medical items and enabling free surgical care around the world. In addition, we are co-financing the construction of a new hospital ship, committing to cover 50% of its cost over the next three years.”  

To close the evening, Dr. Walt Johnson, Director of Strategic Partnerships at Mercy Ships, underscored that partnerships are not just rhetoric; they are the engine driving progress in global surgery. 

“If you recall, Millennium Development Goal 8 was about partnerships. So is SDG 17, which, in reality, remains in existence until 2030,” he said. “Every one of you, whether from member states, regional offices, or academic institutions, has a role and is a partner. Everything we do depends on partnership. It’s fundamental to getting across the finish line for global surgery.”  

With stronger policy implementation, coordinated action, and a shared commitment to equity, the global health community is moving closer to a future where access to surgery is not a privilege, but a guarantee for all.