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The essential role of surgery

Dan Gorenstein Apr 27, 2015

When we think about a global health crisis, we often think about specific diseases. But a new report out Monday in the Lancet challenges that view.

Authors point out a lack of adequate, timely and affordable surgical care resulted in a third of all deaths worldwide in 2010, or nearly 17 million lives—HIV/AIDS, tuberculosis and malaria combined for less than 4 million.

This paper reflects the shifting attitudes towards addressing global health problems. In a concrete way, we now have numbers that help get our arms around the essential role surgery plays.

First, the Lancet Commissioner on Global Surgery, which had input from 110 countries, found that 5 billion people don’t have access to surgery when they need it. Only a tiny sliver of all surgeries occur in the poorest countries.

The bottom line is that many easily treatable conditions effectively become death sentences. For example, 90 percent of maternal deaths could be averted—That’s 100,000 women a year. In the past, a lot of time and money has been devoted to a particular disease like malaria or TB.

But Dr. David Barash, Chief Medical Officer of the GE Foundation, says through combating Ebola, governments, philanthropists and industry are learning that tackling one disease in isolation is limited. Barash says what’s needed is a more robust public health infrastructure.

The awareness of what happened with Ebola really catalyzed everyone’s thinking that ‘Yes, it’s about the system, we need to invest in the system. Industry needs to be a part of that. Foundations need to be part of that. Academics need to be part of that,” he says.

Barash is optimistic this report will lead to action in part because it sets targets.

To improve global access to by 2030, 143 million more surgeries are needed each year, the health workforce must double, and there’s even a price tag: $350 billion.

Of course, the real hope is if you build infrastructure for surgeries, that same infrastructure will serve the public well during the next epidemic.

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