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As progress in combating infectious diseases has led to more children surviving and morbidity reducing, surgical conditions have accounted for a larger share of global ill health. 1 Yet, 5 billion people lack safe, affordable operative care2; approximately 50% of them are children.3 Without decisive action, the Sustainable Development Goals (SDGs) for children’s health will remain out of reach.4 Preventable deaths and life-long disability in childhood can also push families into poverty and sap national productivity.5 Absent, unaffordable, or poor-quality surgical care for children is therefore both a moral and an economic crisis.6 7