Anaesthesia in a modern, global context

Anaesthesia in a modern, global context

  • Issue 68

Julian Gore-Booth
WFSA Chief Executive Office
ceo@wfsahq.org

Note from Jannicke Mellin-Olsen, ESA Secretary. The WFSA is dedicated to improving patient care around the world, representing hundreds of thousands of anaesthesiologists in over 150 countries, including in Europe. The ESA is a Regional Section of the WFSA, meaning that ESA represents the combined European voice to the anaesthesiology world globally. ESA members are active on many levels in the WFSA. As WFSA is the only anaesthesiology partner to the World Health Organization, it means that ESA also has a voice into WHO via the WFSA. It also creates ESA visibility. For instance, at the last meeting of the WHO European Region, the speaker on behalf of the WFSA was ESA President Zeev Goldik.

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With anaesthesia and the future of global health in mind, the incredible Harold Griffith Keynote Lectures given by Dr Atul Gawande and Tore Lærdal were a highlight of the World Congress of Anaesthesiology (WCA) in Hong Kong. Both speakers focused on their personal histories and how they shaped their understanding of anaesthesia in a modern, global context.

Tore Lærdal, Executive Director of the Lærdal Foundation, founder and leader of Lærdal Global Health, and Chairman of Lærdal Medical Corporation, gave a fascinating history of the company, including how his father saved him from a near drowning as a 2-year-old, and how this had inspired him to use his skills as a toymaker to develop life-size dolls for children and later full-size manikins to help train Norwegian healthcare workers and the general public in lifesaving techniques.

He talked of a key moment in his own career: During a visit to rural hospitals in Tanzania in 2008 where he witnessed two newborns dying, he realised that better-trained birth attendants and equipment could have saved their lives. This has fuelled outstanding programmes such as “Helping Babies Survive” and “Helping Mothers Survive” and, in an exciting new partnership between the WFSA and the Lærdal Foundation, support for SAFE training courses to strengthen obstetric anaesthesia in low-income countries.

Dr Atul Gawande similarly discussed his father’s upbringing in a village in rural India, where much of his family still lives. He discussed the economic development that has gradually improved living standards in India, allowing some people to afford private health insurance and driving the development and expansion of hospital services in the biggest town nearby.

He considered how the world will ever manage to close the gaps we have in the capacity to deliver a service as complex as surgical care. ‘People think that it’s about having enough expertise—anaesthesiologists, surgeons, nurses,’ he said. ‘But it is much more than this—it requires somehow building infrastructure, procurement systems, management. And yet as economies grow, numerous countries have managed to do it.’

Gawande then pointed out that although anaesthesia and surgery are considered expensive, the World Bank’s Disease Control Priorities team report (DCP-3 Essential Surgery) found that investment in first-level hospital capacity for 44 essential surgical procedures (including C-section, laparotomy, and fracture repair) is among the most cost-effective health interventions available.

Building the Global Anaesthesia Momentum

Post-World Congress, the WFSA is focusing its attention on defining and promoting the place of anaesthesiologists in global health, and in high-level discussions on universal health coverage. The General Assembly provided an opportunity to introduce the idea of a position statement on the role of anaesthesiology in global health, recognising that provision on the scale needed to meet the challenges of the future must accommodate different models of provision, whilst emphasising that wherever and whenever possible, anaesthesia should be provided, led, or overseen by an anaesthesiologist. Anaesthesiologist leadership is important at all levels to ensure safety and quality of care, and we must take care not be left out of discussions of the specialty, or wider discussions on the global surgical provision.

At the World Congress, the WFSA also launched the SAFE-T (Safe Anaesthesia For Everybody – Today) Campaign. This is made up of the SAFE-T Network of individuals and the SAFE-T Consortium of organisations and aims to unite these groups in order to advance access to safe and affordable anaesthesia worldwide. The campaign highlights the WFSA’s ‘International Standards for a Safe Practice of Anaesthesia’ as a useful measure and tool for helping to define targets and measure progress around universal access.

The SAFE-T Network will raise awareness of the need to advance safe anaesthesia as an essential element of safe surgery, the lack of provision, and the need to take action, by advocating together and gathering data to ‘map the gap’ in access to safe anaesthesia. If you would like to learn more about the SAFE-T Network and how you can become a member, please click here.

The WFSA is in a unique position to bring the whole anaesthesia community together to raise awareness and implement campaigns that will ensure the voice of anaesthesia providers and anaesthesia-focused organisations will be heard by decision makers in the years to come.

Key events include the World Health Assembly in 2017 when we will gather in Geneva with WHO experts, NGOs, and Ministers of Health to report on the progress of Resolution 68.15, ‘Strengthening emergency and essential surgical care and anaesthesia as a component of universal health coverage’. This provides an exciting opportunity not only to ensure that surgery no longer remains the ‘neglected stepchild of global health’, but also that the medical science and practice of anaesthesia takes its rightful position on the international agenda.

The ESA is the European Regional Section of the WFSA.