RCoA supports the call for Universal access to safe, affordable surgical and anaesthesia care when needed

In January 2014, the Lancet Commission on Global Surgery consisting of experts in surgery, anaesthesia, nursing, global health, health policy, management and finance was convened to discuss the case for surgery as an integral component of health care, focusing on the needs of low and middle income countries (LMICS). The Commission’s findings have now been published.

The report provides stark evidence of the numbers of people who lack access to surgical treatment and the devastating effects for individuals and their national economies. The Commission describes the woeful lack of access to surgery for an estimated 5 billion people (representing over 70% of the world’s population) and estimates that of those who do have surgery the financial burden is often crippling with an estimated 81 million people per year becoming impoverished seeking and receiving surgical care. The key messages also describe the number of operations (143 million) needed to alleviate the gaps in access, and crucially, the economic benefits to LMICS of remedying the situation with  projected savings averaging 2% of gross domestic product.

The research highlights that in order to achieve an improvement in access to surgical services four essential areas must be addressed; health systems, workforce, data management and finance.

The future demands for the global healthcare workforce are just as challenging. Based on UN World Population Prospects an additional 2·28 million specialist surgical, anaesthetic, and obstetric providers are needed worldwide to reach the optimum specialist surgical workforce density of 40 per 100,000 population by 2030. To meet this target, the present global surgical workforce would need to at least double in just 15 years.

The RCoA, through the work of the International Programmes department is already active in driving forward change to improve global anaesthesia provision by 2030. The College has a multifaceted approach to this programme of work including:

  • The sponsorship of doctors from developing countries who wish to train for two years in the UK via the Medical Training Initiative system, and subsequently take their skills back to their country of origin
  • Offering support for doctors in resource poor countries in their achievement of postgraduate anaesthetic qualifications, both financially and through provision of training
  • By sharing RCoA educational standards with anaesthetists from developing countries e.g. the Training the Trainers course for Iraqi Educational Supervisors with on-going support
  • Providing access to sit the Primary FRCA Examination to any anaesthetist worldwide
  • Sharing of on-line educational resources, e.g. e-LA, via e-Integrity and the e-SAFE DVD
  • The development of Fellowships for UK trainees in resource poor countries, who follow the specially designed unit of training within the anaesthetic CCT curriculum, enhancing the current and longer term anaesthetic service and training needs for LMICS

The College will continue to support the goals of the Commission on Global Surgery and actively promote improved access to safe and effective anaesthesia to facilitate surgical care wherever and whenever it is required.

30 April 2015