Jaymie A. Henry
1,2,3* 
, Angela S. Volk
4, Sicily K. Kariuki
5, Kiraitu Murungi
6, Trina Firmalo
7, Ruth Laibon Masha
8, Orion Henry
9, Peter Arimi
10, Patrick Mwai
2, Estella Waiguru
5, Evans Mwiti
11, Dan Okoro
12, Angella Langat
13, Cosmas Mugambi
5, Erin Anastasi
14, Gillian Slinger
15, Chris Lavy
16,17, Rosalind Owen
17, Erin Stieber
18, Marc Lester Suntay
19, Danny Haddad
20, Robert Lane
21, Joel Buenaventura
22, Neil Parsan
23, Fizan Abdullah
24, Michael Nebeker
25, Lismore Nebeker
25, Charles Mock
26, Larry Hollier
4, Pankaj Jani
271 The Global Alliance for Surgical, Obstetric, Trauma, and Anesthesia Care (G4 Alliance), Chicago, IL, USA.
2 International Collaboration for Essential Surgery (ICES), Boca Raton, FL, USA.
3 Department of Surgery, Florida Atlantic University (FAU), Boca Raton, FL, USA.
4 Baylor College of Medicine Division of Plastic Surgery, Texas Children’s Hospital, Houston, TX, USA.
5 Ministry of Health Kenya, Nairobi, Kenya.
6 County Government of Meru County, Meru County, Kenya.
7 Provincial Government of Odiongan, Odiongan, Philippines.
8 Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland.
9 Finders Keepers Technologies LLC, Boca Raton, FL, USA.
10 University of Nairobi College of Health Sciences, Nairobi, Kenya.
11 Mount Kenya University (MKU), Thika, Kenya.
12 United Nations Population Fund (UNFPA), Nairobi, Kenya.
13 Beyond Zero Secretariat, Kenya First Ladies’ Office, Nairobi, Kenya.
14 United Nations Population Fund (UNFPA), Campaign to End Fistula, New York City, NY, USA.
15 International Federation of Gynecology and Obstetrics (FIGO), Vancouver, BC, Canada.
16 University of Oxford, Oxford, UK.
17 Global Clubfoot Initiative (GCI), London, UK.
18 Smile Train International, New York City, NY, USA.
19 World Surgical Foundation (WSF) Philippines, Manila, Philippines.
20 Orbis International, New York City, NY, USA.
21 International Federation of Surgical Colleges (IFSC), London, UK.
22 Child Family Health International Philippines, Manila, Philippines.
23 Government of Trinidad and Tobago, Port of Spain, Trinidad and Tobago.
24 Northwestern University Lurie Children’s Hospital, Chicago, IL, USA.
25 Mobile Surgery International, Oaxaca, Mexico.
26 University of Washington Harborview Injury Prevention and Research Center, Seattle, WA, USA.
27 College of Surgeons of East, Central, and Southern Africa (COSECSA), Arusha, Tanzania.
Abstract
While there has been overall progress in addressing the lack of access to surgical care worldwide, untreated surgical conditions in developing countries remain an underprioritized issue. Significant backlogs of advanced surgical disease called neglected surgical diseases (NSDs) result from massive disparities in access to quality surgical care. We aim to discuss a framework for a public health rights-based initiative designed to prevent and eliminate the backlog of NSDs in developing countries. We defined NSDs and set forth six criteria that focused on the applicability and practicality of implementing a program designed to eradicate the backlog of six target NSDs from the list of 44 Disease Control Priorities 3rd edition (DCP3) surgical interventions. The human rights-based approach (HRBA) was used to clarify NSDs role within global health. Literature reviews were conducted to ascertain the global disease burden, estimated global backlog, average cost per treatment, disability-adjusted life-years (DALYs) averted from the treatment, return on investment, and potential gain and economic impact of the NSDs identified. Six index NSDs were identified, including neglected cleft lips and palate, clubfoot, cataracts, hernias and hydroceles, injuries, and obstetric fistula. Global definitions were proposed as a starting point towards the prevention and elimination of the backlog of NSDs. Defining a subset of neglected surgical conditions that illustrates society’s role and responsibility in addressing them provides a framework through the HRBA lens for its eventual eradication.