Solutions for tackling the global surgery crisis in west Africa.

Abstract

The global surgical crisis has become one of the most discussed health topics since the Lancet Commission report published in 2015 because the need is massive, and the consequences are devastating both to countless personal lives and to the economies of low-income and middle-income countries (LMICs). A third of the total global disease burden requires surgical treatment but 5 billion people worldwide (two-thirds of the world's population) do not have access to safe, affordable, and timely surgery. One person dies every 2 seconds from a surgically treatable disease, which is more than the mortality of HIV, tuberculosis, and malaria combined. Nearly half of the world's population would face financial ruin if they accessed surgical care today. 80 million people are driven to financial catastrophe due to the cost of surgery alone or access to surgical care. As a result, countless people suffer and die from a global burden of disease engendered by poverty that can easily be cured. Countries in sub-Saharan Africa fall in the lower third of WHO's Human Development Index because more than two-thirds (up to 69%) of people live on less than £2 a day. The majority (over 90%) of the region's population does not have access to basic surgical and anaesthetic care. Health-care infrastructure in these low-income countries is scarce or non-existent, and there is a shortage of trained health-care providers. Even when those barriers are removed, patients in LMICs face a higher perioperative mortality rate (1% compared with 0·5% in high-income countries).