BACKGROUND

Six billion people lack access to safe, timely and affordable cardiac surgical care [1, 2]. In low- and middle-income countries (LMICs), access to cardiac surgery has been poor due to a multitude of factors, including but not limited to an insufficient workforce, a scarcity of cardiac centres and training programs, fragmented supply chains, variable quality of care, minimal financial risk protection and a lack of political will [2]. In high-income countries, access may be impeded due to geographical, financial and systemic barriers [3]. In 2018, global cardiac surgery was first coined as ‘an area for study, research, practice and advocacy that places priority on improving health outcomes and achieving health equity for all people worldwide who are affected by cardiac surgical conditions or have the need for cardiac surgical care’ [4]. Five years later, encouraging progress has been made, although many gaps still persist.