The National Forum on Global Surgery and Anaesthesia presents the first step towards the objective acknowledgement of the challenges of providing safe, accessible, effective and affordable surgical and anaesthetic care in the South African context. Incorporating the input of local and international, surgical, anaesthetic and public health, academic and non-academic, and private and public stakeholders, the foundation to systematically discuss and tackle issues of infrastructure, workforce, service delivery, financing and information management challenges has been formed. It is now incumbent on us as the medical community to continue this momentum and effect real change.