The 2025 Accra Declaration on Upskilling and Cost- Effective Cardiac Surgery in Africa.

1 , 3 , 17 It is encouraging that there is a positive trend for improvement in the surgical capacity (upskilling the local surgeons—training the trainers by visiting teams including the diaspora “the brains in circulation”) and performance as compared to previous reports ( Figures 2 and 4 ). 1 , 3 Reports in 2020 and 2023 showed surgeon/population ratio of 1:4 million, open heart procedures/population ratio of 2:1 million, heart center/population ratio of 1:16 million).

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