May 6, 2019 marked the 8th biennial meeting of the WHO Global Initiative for Emergency & Essential Surgical Care, where WHO-member countries gave country-level updates on their developing surgical systems. The event marked important progress in implementing meanginful data collection norms framed by WHA Resolution 70.22 calling for “ the continued biennial reporting of emergency and essential surgery and anesthesia progress by Member States coinciding with NCD reporting until the expiration of the SDGs in 2030. Data presented by Dr. Ganbold indicated that access to surgical access is present at an intermediary sub-province level (“intersoum”) and may be more complete than portrayed in high-visibility research articles of the Lancet Commission on Global Surgery, 2015. He indicated future work as needed to generate actionable perioperative surgical mortality data at all facilities. Dr. Lundeg introduced new data revealing high levels of risk for catastrophic expenditure that which accompanies the recent explosion of access to surgical systems which has come about in the last 10 years, affecting 50% of laparoscopic cholecystectomy patients in the country in spite of the clear benefits of the operative approach.