Digestive congenital anomalies: a call for equity in global neonatal surgical care.

Abstract

The global burden of digestive congenital anomalies (DCAs) remains significant, with the recent analysis by Cai et al. highlighting both progress and profound inequities. The disease burden is concentrated in the neonatal period, where the first days of life are a critical window for survival. Optimal outcomes depend on a seamless continuum of care: prenatal diagnosis, delivery at a specialized tertiary center, and immediate postnatal surgery. However, stark disparities in access to this care persist. In high-income countries, multidisciplinary management leads to high survival, while in low- and middle-income countries, delays and limited surgical capacity result in preventable mortality. Beyond treatment, preventive public health measures like maternal nutrition and folate supplementation are crucial. To bridge this equity gap, we must invest in neonatal surgical capacity, integrate DCA care into universal health coverage, and strengthen birth defect surveillance. Ensuring that every newborn with a correctable digestive anomaly has a chance to survive requires coordinated global action to make timely, life-saving surgery accessible to all.