The Unsafe Surgery Crisis
Every year over 4 million people die following surgery - the third greatest contributor to death worldwide.
Surgical care can treat a wide variety of conditions, from cancer and injuries to obstructed labor – up to one third of the global burden of the disease.¹ As such, improving access to safe surgical care is fundamental to the attainment of the UN Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages and for the specific targets within it.² The UN Sustainable Development Goals (SDGs) are the “blueprint to achieve a better and more sustainable future for all”.³
SDG3.8 is focused on the attainment of universal health coverage (UHC) – the goal that everyone, everywhere can access the quality health services they need without risk of financial hardship.4
The Lancet Commission on Global Surgery has found that every year 33 million people face catastrophic expenditure to pay for essential surgery and anesthesia care with a quarter of people facing financial catastrophe as a result of seeking surgical care.5 This burden lands most heavily on the world’s poorest people.
“We don't have a national insurance program or policy yet. We are a low and middle-income country, so we're basically all one illness away from poverty."Dr. Elizabeth Igaga, anesthesiologist, Uganda
In 2015, the WHO and Member States recognized surgical and anesthesia care as being a critical component of UHC. The adoption of World Health Assembly (WHA) Resolution WHA68.15 – which commits to: “Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage” – mandates WHO and Member States’ global actions to ensure safer surgical and anesthesia care.6
Safe surgical care is also fundamental to numerous other targets embedded within SDG3, including: to reduce the maternal mortality ratio to less than 70 in 100,000; to end preventable deaths in neonates and children under-5 by 2030; and to halve the number of deaths and injuries from road traffic injuries, as well as targets to reduce deaths from noncommunicable diseases and increase the health workforce, among others.
Beyond the specific health targets of SDG3, safe surgical care is also an important component of several other SDGs. This includes, among others, targets aimed at poverty reduction, achieving gender equality, and reducing inequalities and promoting peace.7
¹Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. The Lancet [Internet]. 2015 Aug 8 [cited 2022 May 31];386(9993):569–624. Available from: http://www.thelancet.com/article/S014067361560160X/fulltext
2 United Nations. Health – United Nations Sustainable Development [Internet]. [cited 2022 May 31]. Available from: https://www.un.org/sustainabledevelopment/health/
3 United Nations. Health – United Nations Sustainable Development [Internet]. [cited 2022 August 1]. Available from: https://www.un.org/sustainabledevelopment/sustainable-development-goals/
4 World Health Organization. Universal health coverage (UHC) [Internet]. [cited 2022 May 31]. Available from: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)
5 Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. The Lancet [Internet]. 2015 Aug 8 [cited 2022 May 31];386(9993):569–624. Available from: http://www.thelancet.com/article/S014067361560160X/fulltext
6 Agenda item 17.1. ‘Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage’ In: sixty-eighth World Health Assembly, Geneva, 26 May 2015. (A68/VR/9);https://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_R15-en.pdf, accessed 01 August 2022 Agenda item 17.1. ‘Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage’ In: sixty-eighth World Health Assembly, Geneva, 26 May 2015. (A68/VR/9);https://apps.who.int/gb/ebwha/pdf_files/WHA68/A68_R15-en.pdf, (cited 01 August 2022)
7 Roa L, Jumbam DT, Makasa E, Meara JG. Global surgery and the sustainable development goals. British Journal of Surgery [Internet]. 2019 Jan 8 [cited 2022 May 31];106(2):e44–52. Available from: https://academic.oup.com/bjs/article/106/2/e44/6120762®
