Short-term surgical missions (STSMs), which deploy surgical teams from high-resource settings to provide much-needed surgical care in underserved populations in low-resource settings, are a commonly used method of reducing the burden of surgical disease.

To facilitate the much-needed paradigm shift in the way we conceptualize and conduct STSMs, we propose an argument for “diagonal” STSMs as a stop-gap component of global surgical systems strengthening based upon the political justice theory of moral cosmopolitanism.

Hybrid “diagonal approaches” to STSMs have been proposed as the capacity-building model needed to provide immediate benefit and sustainable long-term impact for surgical health system improvement.

Devising and implementing context-specific capacity-building interventions for the surgical care workforce and system-strengthening interventions requires significant community engagement to allow local stakeholders to guide the development and implementation of STSMs and ensure that programs are ethical, culturally sensitive, and sustainable.

The global burden of surgical disease remains largely unmet. While the issue of inequitable access to surgical care, particularly in resource-limited settings, is well described, effective solutions focused on health system expansion and strengthening remain inadequate. Geospatial barriers to care, inadequate surgical and anesthesia workforce density, limited resources and infrastructure, and competing public health priorities mean that health systems in low- and middle-income countries (LMICs) often are unable to meet the surgical needs of their populations.1

Much of the human and capital resources required to ameliorate inequitable surgical care provision and outcomes are concentrated in high-income countries (HICs)1. Many individuals and organizations in high-resourced settings feel compelled to act to reduce health inequity and pursue social justice. Short-term surgical missions (STSMs) are a commonly used method of reducing the burden of surgical disease. These missions deploy surgical teams from high-resource settings to provide much-needed surgical care in underserved populations. While this practice has existed for decades, more recently, …