5 Billion People Lack Access to Surgery

According to a major international study published in The Lancet, two thirds of the world's population have no access to basic surgery and anaesthesia — more than double the number in previous estimates. This means millions of people are dying from treatable conditions like appendicitis, fractures, or obstructed labour.

The study shows that five billion people worldwide do not have access to safe and affordable surgery and anaesthesia when they need it, and access is worst in low-income and lower-middle income countries, where as many as 9 out of 10 people cannot access basic surgical care.

Each year, 313 million operations are performed worldwide and only one in 20 occur in the poorest countries, where over a third of the world's population lives. There is also a global shortfall of at least 143 million surgical procedures every year, the study notes, with some regions needing nearly twice as many additional operations as others.

Previous estimates have only looked at whether surgery was available. The Lancet study has also considered whether people can travel to facilities within two hours, whether the procedure will be safe, and whether patients can actually afford the treatment.

Notably, the new study finds that 25 percent of people worldwide who have a surgical procedure will incur financial catastrophe — costs that they cannot afford and which drive them into poverty — as a result of seeking care. The burden of catastrophic expenditure on surgery is highest in low-income and lower-middle-income countries and, within any country, lands most heavily on poor people.

"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," says Andy Leather, Director of the King's Centre for Global Health, King's College London, UK, and one of the study's lead authors.

A third of all deaths in 2010 (16.9 million) were from conditions treatable with surgery — even surpassing the number of deaths from HIV/AIDS, tuberculosis and malaria combined.

The study examined the case for surgery as an integral component of healthcare. It was written by a team of 25 leading experts from across the fields of surgery and anaesthesia, who spent a year and a half gathering evidence and testimony, from healthcare workers and patients, from more than 110 different countries as part of this report.

The Lancet report provides detailed figures on the economic returns that might be expected to accompany the needed global expansion of surgery. It 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 and a firm commitment to universal health coverage, the report authors say.

The report also provides a much-needed set of indicators and recommendations to improve access to safe and affordable surgery and anaesthesia, and a policy template for national surgical plans.

Source and image credit: The Lancet


Meara JG, Leather AJM, Hagander L et al. (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet, 2015; DOI: 10.1016/S0140-6736(15)60160-X

Published on : Wed, 29 Apr 2015

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Fractures, Surgery, anaesthesia, appendicitis, poverty, obstructed labour According to a major international study published in The Lancet, two thirds of the world's population have no access to basic surgery and anaesthesia — mo

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