Amsterdam Declaration on Essential Surgical Care Published in World Journal of Surgery

In November 2014, global surgical stakeholders assembled in the Netherlands for an international symposium on "Surgery in Low Resource Settings".  Meeting participants drafted a declaration calling upon global leaders to recognize the urgent need to address the lack of surgical capacity in low- and middle-income countries (LMICs).  Supported by 51 global organizations the 'Amsterdam Declaration on Essential Surgical Care' was officially published in the World Journal of Surgery on April 10, 2015. A full copy of the resolution and list of sponsoring organizations is available here

The Amsterdam Declaration on Essential Surgical Care

Being concerned about the fact that:

  • Two billion people have no access to essential surgical care especially in low- and middle-income countries

  • Five million people die from injuries every year; more than 90 % of whom are found in low-resource settings

  • A third of a million women die every year from childbirth; 15–20 % of whom can be saved through safe essential surgical care

  • Two million women live with untreated obstetric fistula; all entirely in low-resource settings

  • Twenty million people suffer from treatable blindness caused by cataract

  • Millions of people suffer from correctable congenital deformities such as cleft lip and clubfoot

  • Surgical conditions now kill more people than HIV, TB and Malaria combined

  • Surgical and obstetric conditions approximately account for 11 % of the world’s disability-adjusted life years (DALYs) lost each year

  • There is a critical shortage in surgically and anaesthetically trained health care workers in low- and middle-income countries (for example, 0.5 surgeon per 100.000 people in Sub Saharan Africa)

  • The medical infrastructure, supplies and observed procedures in low- and middle-income countries are insufficient to provide the needed essential surgical care

Taking into account that:

  • At present there is limited global effort from a public health perspective to reduce the number of deaths and disabilities in low- and middle-income countries caused by surgical conditions

  • Essential surgical care in low-resource settings is cost effective in DALYs and cost competitive to other preventive health measures

  • Making essential surgical care available in low-resource settings requires a multilevel approach

We make the following declaration:

  • We solicit the support of the governments of all nations, the UN, the WHO, the World Bank, institutional donors as well as other major donors, non-governmental organisations, all involved medical and surgical societies, colleges and professional bodies.

To ensure that:

Essential surgery be made available to all regardless of age, gender, race, ethnic group, geographical location, financial status, and political and religious affiliation through the following actions:

  1. Incorporate essential surgical care as part of national health services within universal health coverage (UHC)


  2. Realign and increase the allocation of resources to improve essential surgical care delivery


  3. Make training accessible to health workers providing essential surgical care


  4. Ensure the provision of supplies, equipment, and infrastructure for safe, essential surgical care


  5. Develop protocols for ethical surgical practice, assessment, audit and follow-up


  6. Optimise collaboration amongst all stakeholders such as professional organisations, institutions, charities and funding agencies to avoid duplication and maximise efforts to promote essential surgical care


  7. Support the proposed World Health Assembly resolution ‘Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage’ in May 2015