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The study published by LaGrone et al examines the financial barriers faced by low/middle-income countries (LMICs) in the form of article processing fees (APCs) to publish into, and pay walls to read and access, major surgical journals. 1 The study shines a light on two important issues dealing with equity as it applies to surgical science in terms of (1) access to existing knowledge to improve surgical care in LMICs, and (2) the ability to generate, publish and disseminate new knowledge that may be more relevant and applicable to the LMIC environment. Eighty-six percent of the global population resides in LMICs, and the scale of surgically avertable morality in these countries is staggering. In a World Bank study in 2015, it was estimated that if basic surgical care could be provided to all, approximately 1.5 million lives would be saved in LMICs. 2 Despite this grim statistic, LMICs face an almost unsurmountable …