Colorectal Surgery as a Pillar of Global Health

Gifty Kwakye, MD, MPH, FACS, FASCRS

The decision to focus this edition of Clinics in Colon and Rectal Surgery on Global Surgery could not have been timelier as we continue to struggle with a virus that has claimed almost 6 million lives worldwide. A virus that has reminded us that—although we live in countries divided by race, ethnicity, religion, and economic status—we are actually one big village, with an intrinsically linked fate.

Since its launch in 2014, the Lancet Commission on Global Surgery has drawn attention to the dire state of surgical care in resource-poor settings. In their Global Surgery 2030 report, ¹ the commission highlighted the fact that 1) an alarming 5 billion people worldwide have no access to affordable surgical care; in resource-poor settings this affects 9 out of 10 people, 2) despite accounting for one-third of the world's population, only 6% of surgeries occur in low-income countries, and 3) between 2015 and 2030, resource-poor countries will have an estimated loss of $12.3 trillion in economic productivity. We are seeing an increase in colorectal disorders, particularly cancers, as epidemiologic transitions occur worldwide fueled by industrialization. The associated morbidity and mortality from untreated surgical colorectal disease is staggering. We can no longer ignore the cry for help and the need to act, as we face disparities and inequities in healthcare.

The globally diverse group of authors who contributed to this special edition are not only content experts but also individuals who have dedicated their academic work to understanding and improving systems of care in resource-poor settings. I am grateful for the time they each spent helping to craft this work. The goal is to provide an overview of global health/global surgery, highlight important ethical considerations and present the management of colorectal disorders through the lens of a less-resourced community. Our hope is that it will both educate and inspire readers to join efforts aimed at making basic surgical care affordable and accessible for all regardless of borders.

A special thanks to Dr. Steele for providing a platform for us to share this important work. It is a great privilege and honor for me to serve as a Guest Editor. We indeed stand on the shoulders of giants and a true ally is one who is willing to use their platform to amplify another's voice. Thank you!