Worldwide, 5 billion people lack access to safe, affordable surgical and anaesthesia care.
Every 2 seconds, someone dies as a result of an untreated surgical condition.
Each year, we could save 17 million lives with better access to safe surgery and anaesthesia care.
If we do not invest in expanding surgical systems now, low- and middle-income countries stand to lose 12.3 TRILLION in potential GDP by 2030.
These numbers, and many more like them, have inspired an incredible amount of work and progress around the world, as country leaders and global surgery champions have been advancing the cause of surgical and anaesthesia care. Because of numbers like these, we know the scale of global need. Because of numbers like these, we know the many ways in which surgery and anaesthesia are essential to achieving the global goals and UHC, and we know that the case for investing in surgery is undeniable. The importance of data in global surgery and anaesthesia cannot be overstated.
Thanks to the research teams, practitioners, and champions for global surgery that have invested so much time into the collection of this data, the need for ongoing data collection has been recognized at the global level - in 2014, the G4 Alliance launched a campaign to prioritize surgical care indicators. As a result of this collective advocacy effort, 4 indicators proposed by the Lancet Commission on Global Surgery (LCoGS) have been included in the WHO's 100 Core Health Indicators reference document. Since then, further efforts have been made to prioritize the collection of surgical data, including efforts to include surgical care as part of the Sustainable Development Goals (SDGs) indicators, a global initiative by the LCoG leadership to gather national surgical data from World Bank member countries, and a report endorsed by over 90 organizations and the G4 Alliance presenting a comprehensive dashboard of 15 consensus indicators that build on existing surgery metrics and expand the ability to prioritize surgical systems strengthening around the world.
As a global community, we understand that what gets measured, gets managed. The importance of data is clear.
During the 49th UN Statistical Commission in March 2018, a new global consensus statement on surgery and anaesthesia data was launched! This report - authored by the German Global Surgery Association and the Program in Global Surgery and Social Change at Harvard Medical School, and published by The G4 Alliance - was launched during an expert roundtable discussion hosted in parallel with the 49th UN Statistical Commission.
Background: The Urgent Need for Global Surgery and Anaesthesia Indicators
The SDGs represent a new global agenda that calls for universal action to eradicate poverty, protect the planet and support greater peace and prosperity for all. This inclusive and interconnected agenda provides guidelines and targets for countries and international organizations to track national and global progress, while working collectively towards sustainable development.
One of the core tenets of the SDGs is universal health coverage (UHC), which calls upon world leaders to ensure that all people around the world have access to effective, affordable and quality health care when needed. The provision of surgical and anaesthesia care represents an integral component of UHC and the SDGs.
Recognizing this important linkage, World Health Organization (WHO) Member States unanimously approved resolution WHA68.15 during the World Health Assembly in May 2015, calling for strengthening of emergency and essential surgical and anaesthesia care as an integral part of UHC. This resolution urges countries to prioritize surgical and anaesthesia care as part of national health plans, emphasizing the importance of service delivery, quality, training, workforce, infrastructure and data collection to support monitoring and evaluation.
Despite this global momentum, there remains a paucity of data and information on global surgical and anaesthesia care. Experts estimate that nearly 5 billion people do not have access to safe, affordable surgical and anaesthesia care, contributing to as many as 17 million deaths each year. For those who are able to access care, out of pocket costs can be devastating. An estimated 81 million people are impoverished each year seeking essential surgical services.
When integrated as part of health systems, surgical care represents one of the most cost-effective public health interventions. Integrating safe, effective and affordable surgery into existing health systems has been shown to contribute to economic gains. For every $1 invested in surgical capacity building at the community level, $10 is generated through increased health and productivity.
Aligning surgical and anaesthesia care as part of UHC is a powerful strategy for saving lives, and contributes to the broader sustainable development agenda. However, a robust indicator framework will be essential to guide national, regional and global interventions, and to track progress towards UHC and the sustainable development agenda. The availability of surgical and anaesthesia data will further provide governments with the information needed to develop, implement and monitor national policies and allocate resources effectively.
This global consensus statement focuses on the importance of data collection for surgical and anaesthesia care as an integral part of the SDG framework. The authors and signatories of this statement call for the establishment of an expert working group to analyze and provide recommendations on global surgery and anaesthesia statistics to be presented to the United Nations Statistical Commission in 2019.
The report was launched at a side advocacy event held in parallel with the 49th UN Statistical Commission. Hosted by the G4 Alliance and held at Gradian Health Systems, the event featured an intimate roundtable discussion with report contributors and global surgery data experts.
Dr. Blake Alkire, MD, MPH Representative for PGSSC, Harvard Medical School
Dr. Faye Mazo Evans, Representative for WFSA
Dr. Jose Miguel Guzman, Regional Coordinator, DHS Africa, ICF International
Dr. David Ljungman, MD PhD, Report Co-Author
The session was moderated by Ms. Mira Meheš, Director of Operations with The G4 Alliance. Special remarks were also shared by Dr. Sabrina Juran and Magdalena (Leni) Gruendl, co-authors of the global surgery and anaesthesia statement.
We wish to thank Gradian Health Systems and CEO Mr. Stephen Rudy for welcoming us and hosting our event at Gradian's HQ in New York.