Two thirds of the world’s population lack access to safe, affordable surgical and anaesthesia care when needed, according to initial findings of a report carried out by the Lancet Commission with support from RCSI (Royal College of Surgeons in Ireland).

Global Surgery 2030, the landmark initial report of The Lancet Commission on Global Surgery, published its initial findings in a landmark study: Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development. A 15-year programnme to implement the proposals is being launched in Boston today (6 May 2015).

Global Surgery 2030 analyses the role of surgical and anaesthesia care in improving the health of individuals and the economic productivity of countries. Initial findings from the report found that 5 billion people across the world do not have access to safe, affordable surgical and anaesthesia care and the financial burden of surgical care is such that it is an important contributing factor to poverty for 33 million people.

The findings contained within the interim report outline early thinking and raises a series of questions for the provision of surgical care across the globe. The five main findings of the report are that:

• 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed.
• 143 million additional surgical procedures are needed each year to save lives and prevent disability.
• 33 million individuals face catastrophic health expenditure due to payment for surgery and anaesthesia each year.
• Investment in surgical and anaesthesia services is affordable, saves lives and promotes economic growth.
• Surgery is a central part of, and must not be treated separate from, health care.

According to the findings, over half the global population cannot access timely surgical treatment should they need to. The timely access to surgical care is essential to reduce death and disability from surgical conditions. The report looked at four dimensions of access – timeliness, surgical capacity, safety, and affordability - and found that 5 billion people have inadequate access to essential surgical services. Access to care is worse for individuals in Low to Middle Income countries (LMICs) especially those in Sub-Saharan Africa.

The report also outlined how one quarter of all people who have a surgical procedure will face financial catastrophe as a result of seeking care. This financial burden falls most heavily on the poor and financial catastrophe from seeking surgical care occurs most often for individuals in LMICs, and for those in the poorest wealth quintiles within countries of all income groupings.

Speaking about the findings, Mr Declan Magee, RCSI President said: “This report highlights that millions of people worldwide are dying from conditions such as appendicitis, obstructed labour and compound fractures which are potentially treatable using relatively simple surgical techniques. “Consistent access to safe surgical, anaesthetic and obstetric care when needed will save many lives. Since 2007, RCSI has been working in partnership with the College of Surgeons of East Central and Southern Africa (COSECSA) and with the support of Irish Aid, to expand and develop training programmes in the region and increase the number of specialist surgeons in ten of the poorest countries in the world.

“The Commission have identified that one of the keys to achieving the ambitious goal of training 1.2 million additional specialist surgeons, anaesthetists and obstetricians by 2030 will be the development of partnerships between institutions in high income countries and those in low income regions such as the successful collaboration between RCSI and COSECSA.”

Developed by a multidisciplinary team from over 110 nations, with support from RCSI, the report presents findings on the state of surgical care in low-income and middle-income countries (LMICs), as well as a framework of recommendations, indicators and targets needed to achieve the Commission’s vision of universal access to safe, affordable surgical and anaesthesia care when needed.

An animated infographic is available here