Partnerships for developing pediatric surgical care in low-income countries.

If attendance at a session speaks to the relevance of a topic, then “pediatric surgery in low-income countries: international partnerships” was an important subject for many who attended the 41st annual meeting of the Pacific Association of Pediatric Surgeons. Included on the programwere 4 invited speakers who described their experience with different types of international partnerships for addressing the global burden of pediatric surgical disease. Stephen Bickler of the University of California, San Diego, Calif, opened the session by describing recent international initiatives for improving surgical care in low and middle-income countries. The driving force for these initiatives has been increasing recognition that surgical diseases are an important public health problem. He described work underway to measure the global burden of surgical disease and its relevance in disability adjusted life years lost. He traced the evolution in the assessment of global surgical needs and the impact this work has had on health policy. Important milestones in this research have included (1) costeffective analysis studies in 2003 demonstrating that basic surgical interventions are similar in expense to other public health interventions (eg, immunizations) [1,2], (2) the World Bank's 2006 Disease Control Priorities Project that included surgical care as an important public health intervention [3], and (3) the 2008 Global Burden of Surgical Disease Working Group [4]. Worldwide, an estimated 234 million major