• Megan L Cherewick, Steven D Cherewick, and Adam L Kushner.
• Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: megan.cherewick@gmail.com.
• Surgery. 2017 May 1; 161 (5): 1436-1443.

BackgroundIn 2015, it was estimated that approximately 36.7 million people were living with HIV globally and approximately 25.5 million of those people were living in sub-Saharan Africa. Limitations in the availability and access to adequate operative care require policy and planning to enhance operative capacity.MethodsData estimating the total number of persons living with HIV by country, sex, and age group were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) in 2015. Using minimum proposed surgical rates per 100,000 for 4, defined, sub-Saharan regions of Africa, country-specific and regional estimates were calculated. The total need and unmet need for operative procedures were estimated.ResultsA minimum of 1,539,138 operative procedures were needed in 2015 for the 25.5 million persons living with HIV in sub-Saharan Africa. In 2015, there was an unmet need of 908,513 operative cases in sub-Saharan Africa with the greatest unmet need in eastern sub-Saharan Africa (427,820) and western sub-Saharan Africa (325,026). Approximately 55.6% of the total need for operative cases is adult women, 38.4% are adult men, and 6.0% are among children under the age of 15.ConclusionA minimum of 1.5 million operative procedures annually are required to meet the needs of persons living with HIV in sub-Saharan Africa. The unmet need for operative care is greatest in eastern and western sub-Saharan Africa and will require investments in personnel, infrastructure, facilities, supplies, and equipment. We highlight the need for global planning and investment in resources to meet targets of operative capacity.Copyright © 2016 Elsevier Inc. All rights reserved.

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