Tackling the Biggest Challenges in Global Anaesthesia: Europe and Beyond

Tackling the Biggest Challenges in Global Anaesthesia: Europe and Beyond

  • Issue 71

Gonzalo Barreiro, WFSA President

Europe and the WFSA: historical relationships

In 1955, in Holland, ten years after the end of World War II, the WFSA was created with 26 countries coming together, 15 of which were European. The vision of these people was remarkable: they created a unique global tool for anaesthesia development. Today the WFSA has more than 130 Societies around the world as members). ESA is the European Regional Section.

Many European colleagues were elected as WFSA presidents during these 62 years, and now Jannicke Mellin-Olsen from Norway, the current ESA Secretary, will begin her two year term, from 2018 to 2020.

The World Congress of Anaesthesiologists (WCA), organised by the WFSA, takes place every four years. Popularly named “The Olympic Games of Anaesthesia”, it gathers colleagues from more than 120 countries. The last WCA in Europe was in Paris (2004), and the next one will take place in Prague (September 5-9, 2020; http://www.wcaprague2020.com).

The historical relationship between European anaesthesiologists and the WFSA has been one of generosity and inclusion. The delegation at the first European Congress in Vienna (September 1962) included eight young researchers who were awarded travel bursaries of $1,200 from the Committee for the International Organisation of Medical Societies, UNESCO to attend the meeting. Additionally, speakers at the congress asked for no fees or expenses.

Today, this spirit of support and collaboration continues as a number of scholarships are offered each year to young anaesthesiologists from lower income European countries who wish to attend Euroanaesthesia. Over the past three years alone the WFSA has sent 12 scholars from seven European countries to attend the congress.

However, there is still much more that can be done to tackle the challenges, including the need for workforce scale-up within our profession regionally and globally.

Addressing the global anaesthesia workforce crisis

The Lancet Commission on Global Surgery recently found that 5 billion of the world’s 7 billion population are without access to safe and affordable surgical care and anaesthesia when needed. This crisis must be addressed in order to meet Sustainable Development Goal (SDG) #3, which aims to achieve Universal Health Coverage (UHC) by 2030.1 Achieving UHC is essential in closing the gap in access to healthcare, impacting billions of people.

In May 2017 the WFSA, during the World Health Assembly (WHA), announced the publication of an official Position Statement on Anaesthesiology and UHC.2 The statement, approved unanimously by Extraordinary Resolution of WFSA’s General Assembly, explains that:

There is an urgent need to address deficiencies in access to safe anaesthesia care. An additional 1.27 million surgical, obstetric and anaesthesia providers will be required by 2030 to achieve Universal Health Coverage. In many countries, particularly those with limited resources, anaesthesia is associated with unacceptably high mortality rates. Training and ongoing maintenance of standards are essential for increasing the number of providers and increasing the safety of anaesthesia for patients worldwide.

Non-physician anaesthesia providers are recognised as an essential element in scaling up the provision of safe anaesthesia, but the WFSA is clear that all providers must be led or overseen by a physician anaesthesiologist.

Anaesthesia is complex and potentially hazardous, and optimal patient care depends on anaesthesia being provided, led or overseen by an anaesthesiologist. The WFSA recognises that effective teamwork is a vital component of patient safety.

During the same WHA, the WFSA released the WFSA Global Anaesthesia Workforce,3 an online resource tool mapping the total number of anaesthesia providers worldwide. This map highlights one of the biggest challenges in global anaesthesia: workforce shortages. These shortages impact anaesthesiologists and patients in every part of the world, including Europe, where national differences in the number of physician anaesthesia providers per 100,000 population are evident. The WFSA map highlights ESA countries having fewer than 10 physician anaesthesiologists per 100,000. These figures remain higher than the global average, but they are in contrast with many other ESA countries that have 20 (and more) physician anaesthesiologists per 100,000.

In order to improve patient care across the continent, these differences must be tackled by the WFSA and the ESA jointly in the spirit of collegiality that preceded the founding of a European regional section of the WFSA: the ESA.
The WFSA’s Global Anaesthesia Workforce Map contributes to wider efforts to ensure anaesthesia and surgical care is measured. It enables the WFSA and other organisations to advocate for nations to prioritise safe surgical and anaesthesia care as part of their national health priorities, while keeping anaesthesia and surgery in the consciousness of global health policy makers.

Taking action, campaigning together

As the WFSA continues to advocate for the scale-up of the anaesthesia workforce, we seek to raise awareness and to unite anaesthesiologists behind this initiative. For the past few years World Anaesthesia Day has been the WFSA’s most popular campaigning day of the year, with thousands of anaesthesiologists from around the world taking part. This year we will be running the “Count Me In!” initiative through our Safe Anaesthesia For Everybody – Today (SAFE-T) campaign in support of anaesthesia workforce mapping and scale-up.

To find out more about how you or your society can get involved, please visit www.wfsahq.org/our-work/advocacy

1. Meara JG, Leather Andrew JM, Hagande L, et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;386(9993):569–624.
2. World Federation of Societies of Anaesthesiologists (WFSA). Position statement on anaesthesiology and universal health coverage. Available at http://www.wfsahq.org/latest-news/latestnews/682-wfsa-releases-position-statement-on-anaesthesiology-and-universal-health-coverage-uhc
3.-World Anaesthesiology Workforce. Available at http://www.wfsahq.org/workforce-map