This conference was inspired by the publication of the second edition of Disease Control Priorities in Developing Countries (DCP2) which suggested, contrary to prevailingopinion, that surgical services can be provided in district hospitals in developing countries, at a cost per disability-adjusted lifeyear (DALY) that is ‘at par with other well-accepted preventive procedures, such as immunization for measles and tetanus and home care for lower respiratory infections’. This publication, combined with the establishmentof the World Health Organization (WHO) Global Initiative for Emergency and Essential Surgical Care, highlights that surgical services, hitherto neglected, have an important role to play as preventive and life-saving strategies in public health

The conference, hosted by the Rockefeller Foundation’s Bellagio Conference Center, brought together leaders in surgery, anesthesia, health policy, epidemiology and health economics from Eritrea, Ghana, Kenya, Malawi, Mozambique, Southern Sudan, Sweden, Tanzania, Uganda, USA, and WHO to examine the necessary steps to increase access to surgical services particularly in rural sub-Saharan Africa. Its goals were:

1. To take stock of what is known about the need to improve access to surgical services in sub-Saharan Africa, the cost-effectiveness of specific interventions and existing national and international efforts to support the delivery of these interventions;

2. To assess health system and human resource constraints to integrating surgical services at the district level within health systems in sub-Saharan Africa, and identify training programs, resource real location and policies required to tackle these challenges; and

3. To prepare a roadmap of activities to improve access to surgical services in sub- Saharan Africa and to engage national and international stakeholders to advocate for and implement this roadmap