Two thirds of the world have no access to surgery


Two thirds of the world’s population have no access to safe and affordable surgery, finds new study

New estimates suggest that number of people worldwide who are unable to access basic surgery and anaesthesia is more than twice as high as previously thought

Five billion people worldwide do not have access to safe and affordable surgery and anaesthesia when they need it. As a consequence, millions of people are dying from common, easily treatable conditions like appendicitis, fractures, or obstructed labour. This is according to a major new Commission co-led by experts at King’s College London, and published today in The Lancet.

Just under a third of all deaths in 2010 (32·9%, 16·9 million deaths) were from conditions treatable with surgery – well surpassing the number of deaths from HIV / AIDS, TB, and malaria combined.  Access is worst in low-income and lower-middle income countries, where as many as nine out of ten people cannot access basic surgical care.

Despite this enormous burden of death and illness –which is largely borne by the world’s poorest people – surgery has, until now, been overlooked as a critical need for the health of the world’s population.  As a result, untreated surgical conditions have exerted substantial but largely unrecognized negative effects on human health, welfare, and economic development.

“In the absence of surgical care, common, easily treatable illnesses become fatal,” says Andy Leather, Director of the King’s Centre for Global Health, and one of the Commission’s lead authors.  “The global community cannot continue to ignore this problem – millions of people are already dying unnecessarily, and the need for equitable and affordable access to surgical services is projected to increase in the coming decades, as many of the worst affected countries face rising rates of cancer, cardiovascular disease, and road accidents.”*

Of the 313 million operations done worldwide each year, just one in 20 occur in the poorest countries, where over a third of the world’s population lives.  New estimates produced for the Commission find that there is a global shortfall of at least 143 million surgical procedures every year, with some regions needing nearly twice as many additional operations as others.  

The Commission estimates that with an investment of $US 420 billion, a cost far outweighed by the devastating economic costs incurred by the current global shortfall in access to surgery, the countries where access is weakest could be scaled up to acceptable, and achievable, levels of access to surgery by 2030.  This highly cost-effective investment in surgery needs to be accompanied by sustainable financing mechanisms across the health care system, say the authors, and a firm commitment to universal health coverage.

The Commission was written by a group of 25 leading experts from across the fields of surgery and anaesthesia, with contributions from more than 110 countries.  It calls for recommendations to improve access to safe and affordable surgery and anaesthesia, and a policy template for national surgical plans.

The Commission will be launched on Monday 27 April with a day-long symposium at the Royal Society of Medicine in London, UK, followed by a daylong conference Global surgery, anaesthesia, and obstetrics: shifting paradigms and challenging generations organised by the Royal Society of Medicine and Royal College of Surgeons of England.

Notes to editors:

* Quotes direct from author and cannot be found in text of Commission.

The commission can be accessed here

The King’s Centre for Global Health is a joint centre for King’s College London and King’s Health Partners, bringing together people working and studying at the university and Guy’s and St. Thomas’, King’s College Hospital, and South London and Maudsley NHS Foundation Trusts.

Photograph credit and captions:

1. © Lifebox Foundation/Amber Lucero Dwyer: Female patient monitored using Lifebox pulse oximeter [essential oxygen monitor] during emergency Caesarean section [landscape view]

2. © Lifebox Foundation/Collaborate: ideas & images: Old hospital bed outside operating theatre block in hospital

For further media information or interviews with Andy Leather, please contact the King’s College London Press Office [email protected] / +44 (0)20 7848 3202 / +44 (0)7711 466702 (out of hours)