The war torn or famine stricken under developed countries such as Somalia, Ethiopia and Rwanda clearly have very basic health care needs. Primary and preventive strategies should be the priority. However, in politically stable
developing countries such as Papua New Guinea where food supplies are available and primary health care services and infrastructure are developed, there is a need for adequately resourced and staffed secondary and tertiary health care facilities. The World Bank report emphasises primary and preventive health care to the exclusion of specialist services.1 It is a fallacy to argue that these services are unaffordable luxuries. Many lives can be saved and much crippling morbidity prevented by the provision of surgical services. This no less applies to neurosurgery. Unfortunately, this is not the intention or priority of many of the governments of the developing world, the World Bank or the World Health Organization.
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