**Almost everyone will need surgery in their lifetime, but in Africa nearly 95% of the population do not have affordable surgery and anaesthesia.

More people die after surgery than from HIV, TB, and malaria combined.**

In Africa, adults are twice as likely to die after surgery, and for children that number rockets to eleven. Mothers who need caesarean sections face the greatest risk: the mortality rate is fifty times higher than high-income countries. Most of these deaths do not happen in the operating theatre, but on the ward during recovery.

Through extensive research and personal narratives from physicians across the continent, Professor Bruce Biccard provides a history of death and surgery, describes the current state of surgery in Africa, and presents two models for improving surgical care and outcomes.

Fortunately, the solutions are simple and cost-effective, but making them happen has never been easy; even the basic hygiene we now take for granted was once met with resistance. So Bruce presents a manifesto for surgical health, showing us all how to make the world a healthier place.