The Lancet: Five billion people lack access to proper surgical care

Inadequate resources will cost the global economy $12 trillion by 2030

Inadequate access to surgery kills nearly 17 million people each year, more than the total deaths from HIV, tuberculosis, and malaria combined, according to a report from The Lancet Commission on Global Surgery.

Twenty-five experts worked for over a year to produce the report, which was published Sunday in the journals Surgery and Lancet Global Health and calls for increased investment in surgical care in the world's poorest countries.

A global killer

The authors write that five billion people cannot access safe surgical care. As a result, millions of people die from treatable conditions and injuries, such as appendicitis, obstructed labor, and hernias.

According to the report, about 143 million additional surgical procedures would be needed each year to improve global health.

Andy Leather, an author of the report and director of the King's Centre for Global Health, says, "In the absence of surgical care, common, easily treatable illnesses become fatal." He called for increased action from the international community. "The global community cannot continue to ignore this problem – millions of people are already dying unnecessarily," he says.

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The report also finds that approximately 25% of people who undergo surgery each year face "financial catastrophe" as a result.

The report estimates that inadequate surgical care will cost the global economy $12.3 trillion from now to 2030.

Not enough resources

One reason for the lack of access to surgery is the shortage of trained surgeons. Although the United Kingdom has 35 surgical specialists for every 100,000 people, Bangladesh has 1.7 surgeons for the same number of people. And Ebola-ravaged Sierra Leone has just less than one.

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John Kletjian, a professor of global surgery at Harvard Medical School and author of the report, says there is a "pervasive misconception" that only rich countries can provide adequate surgical care. "Although the scale-up costs are large, the costs of inaction are higher and will accumulate progressively with delay," he says.

The authors call for a global investment of $420 billion to improve the surgical access in 88 countries that have the highest need, such as China, India and South Africa (Gorenstein, Marketplace, 4/27; Mazumdar, BBC News, 4/27; McNeil, New York Times, 4/27; Whiting, Reuters, 4/27).

The takeaway: A new report concludes that the lack of access to surgical services kills more people than malaria, HIV, and tuberculosis combined. The report authors call for increased investment in the world's surgical workforce to stop preventable deaths.


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