By: 24 June 2015
Lack of safe surgery and anaesthesia lead to a third of all deaths worldwide

Lack of safe surgery and anaesethesia lead to a third of all deaths worldwide

Five billion people worldwide do not have access to safe surgery and anaesthesia, according to a recent report from the Lancet Commission on Global Surgery.

In 2010, nearly 17 million people died from conditions needing surgical care – more deaths than from malaria, AIDS and tuberculosis combined – according to the report, which was written by 25 leading experts in surgery and anesthesia with contributions from more than 110 countries.

The Lancet Commission on Global Surgery consisting of experts in surgery, anaesthesia, nursing, global health, health policy, management and finance was convened in January 2014 to discuss the case for surgery as an integral component of health care, focusing on the needs of low- and middle-income countries (LMICS).

The Commission’s findings provide stark evidence of the numbers of people who lack access to surgical treatment and the devastating effects for individuals and their national economies. There is a woeful lack of access to surgery for an estimated 5 billion people (representing over 70% of the world’s population), and for those who do have surgery the financial burden is often crippling – with an estimated 81 million people per year becoming impoverished seeking and receiving surgical care. The report’s key messages also describe the number of operations (143 million) needed to alleviate the gaps in access, and crucially, the economic benefits to LMICS of remedying the situation with projected savings averaging 2% of gross domestic product.

The research highlights that in order to achieve an improvement in access to surgical services four essential areas must be addressed: health systems, workforce, data management and finance.

The future demands for the global healthcare workforce are just as challenging. Based on UN World Population Prospects an additional 2·28 million specialist surgical, anaesthetic, and obstetric providers are needed worldwide to reach the optimum specialist surgical workforce density of 40 per 100,000 population by 2030. To meet this target, the present global surgical workforce would need to at least double in just 15 years.

The Royal College of Anaesthetists (RCoA) is already active in driving forward change to improve global anaesthesia provision by 2030, through the work of its international programmes department. The college’s multifaceted approach to this programme includes the sponsorship of doctors from developing countries who wish to train for two years in the UK via the Medical Training Initiative system, and subsequently take their skills back to their country of origin. RCoA also offers support for doctors in resource-poor countries in their achievement of postgraduate anaesthetic qualifications, both financially and through provision of training and will continue to support the goals of the Commission on Global Surgery and actively promote improved access to safe and effective anaesthesia to facilitate surgical care wherever and whenever it is required.