Surgical Care Platform

The focus for the surgical care platforms, alongside enhancements to the quality of care, is to address the problem of low surgical volume in the face of considerable unmet need. The large global burden from surgical disease is now recognized as one of the more neglected areas in global health.

In a recent Lancet Commission, a third of all lives lost in the year 2010 were estimated to have been due to health conditions needing surgical care1, with a 90% treatment gap for basic surgical care in lower-income countries. Beyond mortality, untreated surgical diseases are among the top 15 causes of physical disability worldwide. More than 11% of the world’s burden of disease stems from conditions that can be treated successfully with surgery. In 2006, in the second edition of Disease Control Priorities in Developing Countries, surgical care was identified for the first time as a cost-effective investment2. Improved access to high quality surgical care has the potential to improve economic output through improved population health.

Still, an estimated 2 billion people lack access to even the most basic surgical care. Equity is a major issue. The biggest unmet need for surgical care is borne by the poorest sector of society. Surgery is generally curative and prevents the social and economic disadvantages arising from untreated disabilities. Where surgical capacity has developed, it has done so disproportionately in urban areas, and is often viewed as serving socioeconomically advantaged people, to the neglect of rural populations.

To address these issues the Lancet Commission on Global Surgery set five key targets to be met by 2030: 80% coverage of essential surgical and anaesthetic care; at least 20 surgical, anaesthetic, and obstetric physicians per 100 000 population; 5000 surgical procedures/100,000 population; perioperative mortality tracked in 100% of facilities; full protection against impoverishment from out-of-pocket payments for surgical and anaesthesia care.

We are researching HSSS within surgical care in Ethiopia (work package 3) and Siera Leone (work package 7).

References

  1. Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;:10–6736.
  2. Dean T. Jamison & Joel G. Breman & Anthony R. Measham & George Alleyne & Mariam Claeson & David B. Evans & Prabhat Jha & Ann Mills & Philip Musgrove, 2006. “Disease Control Priorities in Developing Countries, Second Edition,” World Bank Publications, The World Bank, number 7242, September.