Reflections from the World Health Assembly 2018

Frustration at the lack of progress on increasing access to surgery and anaesthesia

This year when health ministers from around the world met in Geneva for the World Health Assembly they focused on improving access to Universal Health Coverage (UHC). The noble objective is to scale-up healthcare rather than focus on individual diseases such as AIDS, TB and malaria. 

Unfortunately, Universal Health Coverage has not yet grabbed people's imagination to the same extent as earlier global campaigns like polio elimination, massive scale-up of vaccines to reduce life-threatening childhood illnesses, or improvement to HIV testing and AIDS treatment did. Where does this leave the issues of access to surgical and anaesthesia care? 

We are currently seeking partners that want to strengthen essential health systems by scaling up access to surgical and anaesthesia care.

Preaching to the choir

The Surgical Equity Prize team at Nesta travelled to Geneva with the WFSA, G4 Alliance and Lifebox teams and with strong support from the WHO to promote the scale-up of safe surgery and anaesthesia as part of UHC.

The path to successfully achieving this was clearly outlined in the Lancet Commission on Global Surgery in 2015.

  • We need to fill a gap of 143 million additional operations each year in low and middle income countries. 
  • Untreated surgical conditions lead to loss of 16.9 million lives, four times more deaths than AIDS, TB and malaria combined in 2010. 
  • 81 million of those who are able to receive care are left impoverished each year as a result. 
We have left Geneva feeling like we were just preaching to the converted.

The WHA68.15 resolution was put in place three years ago to recognise the grave repercussions of lacking safe, affordable and accessible surgical and anesthetic services as part of primary care. It urged WHO Member States to strengthen emergency and essential surgical care and anaesthesia as a component of Universal Health Coverage. Nevertheless, this year’s Assembly did not produce any new, bold commitments to scale-up surgery. We left Geneva feeling that we were just preaching to the converted.

We held an event at the Geneva Press Club explaining our mission - you can watch it here: 

A coalition of communities

There are plenty of discreet efforts doing their best. Maternal health advocates want to make sure that women who need them have access to safe, quality caesarian section. Those championing children’s health seek to ensure that all born with congenital abnormalities get a fair start in life. The list keeps on growing: cancer interventions, cataract removal, mitigating traffic injuries or burns. All of these are among many that point to the same, cross-cutting problem - the lack of access to safe surgical and anaesthetic care.

Perhaps there is a positive way forward in creating a coalition of these communities. The consolidated effort could shift mindsets and create a sense of urgency for international organisations like the World Bank and bi-/multilateral aid efforts to address the massive gap in the provision of safe surgical and anaesthesia care. That’s why we would like to build a Surgical Equity Prize.

Looking at accessing surgery and anaesthesia care through the lens of equity reminds us that it’s not only the problem of good health and wellbeing but also of poverty and inequality.

We are currently seeking partners that want to see a global awareness campaign on surgical equity alongside a challenge competition incentivising solutions to strengthen essential health systems by scaling up access to surgical and anaesthesia care in LMICs, both of which are so badly needed.

A massive coalition of the willing financed and  scaled-up AIDS, TB and malaria prevention and treatment it is time for focus on surgery scale-up.