Global Health Policy
The Lancet Commission on Global Surgery
In 2015 The Lancet Commission on Global Surgery published a seminal paper for global anaesthesia and surgery which highlighted that more than 5 billion people are without access to safe and affordable surgical care when needed.
The WFSA was closely involved with the work of the Commission. Former WFSA Council member Dr Iain Wilson was a Commissioner and Board member Dr Wayne Morris and CEO Julian Gore-Booth were both panellists at the launch event. The WFSA’s initial feedback to the Commission can be downloaded here.
We also recommend reading another important text which focuses on the economic argument for surgical scale-up, the Disease Control Priorities 3 (DCP-3) report on Essential Surgery which includes a chapter on anaesthesia and perioperative care.
The WFSA has official liaison with the World Health Organisation (WHO) and works with WHO staff to ensure the role of anaesthesia within global health is considered by the organisation and by UN Member States. Additionally, the WFSA works with other international bodies and decision-makers to advance anaesthesia in the global health agenda.
WHA Resolution 68:15
As an organisation that has official relations with the WHO the WFSA actively supported agenda item 68:15 “Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage” through to the unanimous passing of a resolution at the 68th World Health Assembly on 22nd May 2015. This forms part of, and influences, our wider response to the global crisis in surgery and anaesthesia.
The 70th World Health Assembly (WHA), held in Geneva in May 2017, was an opportune occasion to discuss the role of anaesthesia and surgery within the global health agenda with stakeholders and decision-makers from around the world two years after Resolution 68.15 was passed.
The WFSA made four statements at the Assembly and commended states that have initiated the development of national surgical, obstetric and anaesthesia plans (NSOAPs), and urged others to do the same. Additionally, the WFSA, along with Lifebox, held a side-event at the WHA entitled “What next for surgery and anaesthesia? Civil society & global solutions” which explored the future of global surgery and anaesthesia. Please click the link above to watch a recording of the event.
Thanks to the hard work of the WFSA and a number of country delegations and organisations working to progress the Resolution, member states approved an amendment calling upon the Director-General to provide a progress report on WHA Resolution 68.15 every 3-years until 2030.
Ketamine and international drug policy
With some countries calling for international restrictions, the WFSA has been coordinating an international response to Governments and the WHO since 2014, to limit the potential threat to the availability of ketamine as an essential anaesthesia drug. The #KetamineIsMedicine Campaign was set in response to calls for the UN Commission on Narcotic Drugs (CND) to ’schedule’ ketamine under the 1971 Convention on Psychotropic Substances.
The WFSA has set up a Ketamine Campaign Resource Hub as part of a wider campaign to urge anaesthesiologists, medical staff, and those against scheduling ketamine, to learn more and raise their concerns. More than 80 organisations, including the WFSA, Save the Children, Oxfam, Operation Smile and others have endorsed a ketamine fact sheet which you can view below:
WHO Every Newborn: an action plan to end preventable deaths
As safe anaesthesia and surgery are an essential component in ending preventable deaths in newborns, the WFSA was invited to provide feedback on the WHO's draft action plan.
The draft plan made no mention of anaesthesiology despite the impact of obstetric and paediatric anaesthesia in preventing neo-natal deaths and in managing pain for mothers during delivery, however the WFSA's advocacy efforts were successful and the final draft of Every Newborn: an action plan to end preventable deaths does include a reference to anaesthetic staff (see page 26) as well as more detail on bag and mask resuscitation.
The UN Sustainable Development Goals (SDGs) and the future of global anaesthesia policy
When the United Nations (UN) created the Millennium Development Goals (MDGs) in the year 2000, the priority areas of anaesthesia and surgery were not mentioned specifically in MDG 6 which seeks to "Combat HIV/AIDS, Malaria and Other Diseases". Since 2000 there has been notable success in tackling child mortality, maternal health and specific diseases such as HIV/AIDS, Malaria and Tuberculosis, however the neglect of surgical care has exacerbated the crisis that we have today with five billion people unable to access safe, affordable surgical and anaesthesia care when needed.
The Sustainable Development Goals (SDGs), launched in 2015, give the world an opportunity to ensure that mistakes are not repeated and that universal access to safe surgery and anaesthesia are highlighted in SDG 3 "Ensure Healthy Lives...". This is work in progress as the SDGs do not specifically mention surgical and anaesthesia care so we are seeking to influence the agenda through other more established avenues such as:
- Universal Health Coverage (UHC)
- Health System Strengthening
- Mother and Child Health (MCH)
- Non-Communicable Diseases (NCDs)
- Road traffic accidents
You can download Health Priorities Post 2015 a paper written by members of WFSA and Lifebox outlining why surgical care must be given priority on the post 2015 health agenda. WFSA is also a proud co-signatory of the Amsterdam Declaration which, together with 50 other organisations, calls for the inclusion of anaesthesia and surgery in the SDGs.
In 2019 the WFSA and the G4 Alliance also released a response to the Political Declaration of the third high-level meeting of the General Assembly on the prevention and control of non-communicable diseases (NCDs), which you can read here. In this response, the WFSA and the G4 Alliance welcome the public commitment reaffirmation of efforts to combat NCDs, but draw attention to some concerns about the Declaration including placing such singular emphasis on prevention of NCDs, overlooking the need for detection, diagnosis, treatment and management, which may, in turn, require anaesthesia and surgery. You can access the UN's Political Declaration here.