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5bn people 'lack access to surgery'

A large majority of people in the world do not have access to safe and affordable surgery, according to a new report.

An estimated five billion people, from a total population of seven billion, are unable to get surgical help when they need it, said researchers.

In low and middle-income countries as many as nine out of 10 individuals were said to lack basic surgical care.

As a result, millions of people were dying needlessly from common and easily treated conditions such as appendicitis, fractures and childbirth complications, the authors claimed.

Researcher Andy Leather, director of the King's Centre for Global Health at King's College London, said: "In the absence of surgical care, common, easily treatable illnesses become fatal.

"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 performed around the world each year, just one in 20 takes place in the poorest countries housing more than a third of the global population, said the authors writing in The Lancet medical journal.

The study, carried out by a commission of 25 leading experts, identified a global shortfall of at least 143 million surgical procedures a year.

A quarter of those who undergo surgery will incur "financial catastrophe" - costs that drive them into poverty, the researchers added.

Acceptable levels of surgery access could be achieved in the worst affected countries by 2030 with a global investment of 420 billion US dollars (£277.46 billion), the report pointed out.

The cost was "far outweighed" by the economic toll caused by the lack of access to surgery.

Commission lead author Professor John Meara, from Harvard Medical School in the US, said: "Although the scale-up costs are large, the costs of inaction are higher, and will accumulate progressively with delay.

"There is a pervasive misconception that the costs of providing safe and accessible surgery put it beyond the reach of any but the richest countries. But our work for this commission clearly shows that not only are the costs of providing these essential services lower than might have been thought, but that scale-up of surgical and anaesthesia care should be viewed as a highly-cost-effective investment, rather than a cost.

"Surgical conditions - whether cancers, injuries, congenital anomalies, childbirth complications, or infectious disease manifestations - are ubiquitous, growing, and marginalising to those who are afflicted by them."


From Belfast Telegraph