Directors statement

This film emerged from a decade of field observation, grounded in the belief that suffering that can be alleviated should no longer remain hidden.

The “lottery of health” — that surgical conditions are treated or ignored based on geography and system capacity — drives both the core narrative but my personal ambition respect the hundreds of vulnerable people who shared their stories.

Whilst as an individual I have an anecdotal view of this issue, I am also driven by the literature of those who study this field and have compiled some resources for the audience to read further.



Global Surgery 2030: Evidence and Solutions

for Achieving Health, Welfare, and Economic Development**

📄 John G. Meara et al., The Lancet (2015)

This is the seminal paper from the Lancet Commission on Global Surgery. It quantifies the global burden of unmet surgical need and sets out a roadmap toward universal access by 2030. Highlights include:

  • 5 billion people lack access to safe, affordable surgical and anesthesia care.

  • 143 million additional procedures needed annually to prevent disability and death.

  • The paper proposes indicators and investment strategies for surgical systems strengthening. The Lancet+1

Global Surgery 2030: A Roadmap for High-Income Country Actors

📄 JS Ng-Kamstra et al., BMJ Global Health (2016)

This consensus paper extends the Lancet Commission’s findings and focuses on how high-income country actors can ethically engage to close surgical access gaps. It emphasizes:

  • Equity and partnership rather than colonial models of aid.

  • Integrating surgical access into broader health systems strengthening.

  • Alignment with Sustainable Development Goals (SDGs). PMC

Evaluating the Status of Lancet Commission Indicators

📄 S. Zadey et al., The Lancet Regional Health – Southeast Asia (2023)

This review looks at the six core indicators proposed by the Lancet Commission for surgical access and assesses their implementation in a major LMIC (India).

  • It highlights large subnational variations in access, surgical volume, and financial risk protection.

  • Demonstrates that many surgical systems fall short of 2030 targets. ScienceDirect

Demand-Side Barriers to Surgical Care in LMICs

📄 S. Rauf et al., BJS (2024)

This scoping review complements supply-side research by exploring patient-centred barriers that keep people from seeking and receiving surgical care — including distance, cost, fear, and cultural factors.

  • Pulls evidence from nearly 3,000 studies across 6 continents.

  • Shows that even when services exist, structural and social barriers limit use. OUP Academic

Surgical Health Policy 2025–35: Strengthening Essential Services for Tomorrow’s Needs

📄 D. Nepogodiev et al., The Lancet (2025)

A recent Lancet policy paper updating progress and challenges since Global Surgery 2030.

  • Notes that progress has been too slow and uneven — especially for workforce strength and financial risk protection.

  • Discusses systemic barriers, unintended consequences of early benchmarks, and evolving strategies to meet SDG-aligned goals.