FAIRFIELD, Conn.--(BUSINESS WIRE)--Millions of people are dying from common, easily-treatable conditions like appendicitis, fractures, or obstructed labor because they do not have access to proper surgical care, according to a major new Commission, published in The Lancet. The Commission reveals that five billion people worldwide do not have access to safe and affordable surgery and anesthesia when they need it, and access is worst in low- and lower-middle income countries, where as many as nine out of ten people cannot access basic surgical care.
Just under a third of all deaths in 2010 (32.9%, 16.9 million deaths) were from conditions treatable with surgery – well surpassing the number of deaths from HIV / AIDS, TB, and malaria combined. Yet despite this enormous burden of death and illness – which is largely borne by the world’s poorest people – surgery has, until now, been overlooked as a critical need for the health of the world’s population. As a result, untreated surgical conditions have exerted substantial but largely unrecognized negative effects on human health, welfare, and economic development.
“In the absence of surgical care, common, easily treatable illnesses become fatal,” says Andy Leather, Director of the King’s Centre for Global Health, King’s College London, UK, and one of the Commission’s lead authors. “The global community cannot continue to ignore this problem – millions of people are already dying unnecessarily, and the need for equitable and affordable access to surgical services is projected to increase in the coming decades, as many of the worst affected countries face rising rates of cancer, cardiovascular disease, and road accidents.”
Of the 313 million operations done worldwide each year, just one in 20 occur in the poorest countries, where over a third of the world’s population lives. New estimates produced for the Commission find that there is a global shortfall of at least 143 million surgical procedures every year, with some regions needing nearly twice as many additional operations as others.
“The GE Foundation and our partners have been implementing programs to address the significant impediments to improve access to healthcare and increase capacity for global safe surgery for over 10 years,” says Dr. David Barash, Executive Director, Global Health Portfolio, and Chief Medical Officer, GE Foundation. “Through our focus areas we are providing innovative solutions that have lasting impact, such as sustainable biomedical equipment technician training and anesthesia training for nurses, safe water solutions in health facilities, and oxygen production and delivery in low-resource settings. To that end, we are shifting our investment strategy to focus of global safe surgery. We are pleased to be included in this important Commission and the broader global health community in prioritizing access to safe surgery globally.”
Despite the overwhelming magnitude of the problem, the Commission estimates that the countries where access to surgery is weakest could be scaled up to acceptable, and achievable, levels of access to surgery by 2030 with an investment of $US 420 billion, a cost far outweighed by the devastating economic cost to countries, communities, and families incurred by the current global shortfall in access to surgery. This highly cost-effective investment in surgery needs to be accompanied by sustainable financing mechanisms across the health care system, say the authors, and a firm commitment to universal health coverage.
The Commission provides detailed figures on the economic returns that might be expected to accompany the needed global expansion of surgery, noting that between 2015 and 2030 surgical conditions will be responsible for a cumulative loss to the global economy of $20.7 million or 1.3% of projected economic output. The Commission also includes a much-needed set of indicators and recommendations to improve access to safe and affordable surgery and anesthesia, and a policy template for national surgical plans. It is accompanied by a substantial body of original research which was used to inform the Commission’s findings, and is published in the journals Surgery and The Lancet Global Health.
“Although the scale-up costs are large, the costs of inaction are higher, and will accumulate progressively with delay,” says Commission lead author John Meara, Kletjian Professor in Global Surgery at Harvard Medical School, USA. “There is a pervasive misconception that the costs of providing safe and accessible surgery put it beyond the reach of any but the richest countries. But our work for this Commission clearly shows that not only are the costs of providing these essential services lower than might have been thought, but that scale-up of surgical and anesthesia care should be viewed as a highly-cost-effective investment, rather than a cost.”
The Commission was written by a group of 25 leading experts from across the fields of surgery and anesthesia, with contributions from more than 110 countries. The report examines the case for surgery as an integral component of health care, focusing on low- and middle-income countries, where need is greatest. The GE Foundation was one of several contributors to the report, including a case study on BMET training being led by its partners Duke University and Engineering World Health, found in the appendix.
The Commission will be launched on Monday, April 27 with a day-long symposium at the Royal Society of Medicine in London, UK, followed by a day-long conference, “Global surgery, anaesthesia, and obstetrics: shifting paradigms and challenging generations,” organized by the Royal Society of Medicine and Royal College of Surgeons of England. Immediately following will be the North American launch on May 6th in Boston, with a day-long event discussing the Commission's key findings and the role of various stakeholders in building a movement for sustainable, resilient health systems. The GE Foundation will be participating in panel discussions at both events, speaking to the implementation of the Commission’s recommendations.
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NOTES FOR EDITORS:
For full Commission, see: http://www.thelancet.com/commissions/global-surgery
For infographic, see: https://youtu.be/bRf8PbQgjGU