Disease Control Priorities, 3rd Edition Focuses on Essential Surgery as Critical to Health Systems Strengthening

In 2015-2016, the World Bank will publish nine volumes of Disease Control Priorities, 3^rd edition (DCP3). Volume 1, Essential Surgery discusses basic and emergency surgical care that can be provided by district hospitals, identifying and defining 44 procedures that are essential based on their ability to address population needs, cost-effectiveness, and feasibility. The volume includes chapters on the global burden of surgical disease, essential surgical interventions, surgical platforms and policies, and the economics of surgery. (¹⁾

This report is released in the midst of growing recognition of the importance of surgery in health system development. Research over the last two decades refutes the common assumptions that surgery is costly and low in effectiveness. DCP, 2nd edition, published in 2006, dedicated a chapter to surgery and provided initial estimates of surgical disease burden. The dedication of a full volume to the topic in this most recent edition speaks to the burgeoning knowledge base and understanding of surgical need around the world. The work of the World Health Organization’s Global Initiative for Emergency and Essential Surgical Care and the recent creation of the Lancet Commission on Global Surgery also demonstrate the increasing attention being paid to the role of surgical care in health systems strengthening.

Key messages from DCP3 on essential surgery (²⁾:

1. Provision of essential surgical procedures would avert about 1.5 million deaths a year, 6-7% of all avertable deaths in low- and middle-income countries.
2. Essential surgical procedures rank among the most cost-effective of all health interventions.
3. Measures to expand access to surgery have been shown to be safe and effective while countries make long-term investment in building surgical and anesthesia workforces.
4. Substantial disparities remain in the safety of surgical care, driven by high perioperative mortality rates including anesthesia-related deaths in low- and middle-income countries.
5. The large burden of surgical disorders, cost-effectiveness of essential surgery, and strong public demand for surgical services suggest that universal coverage of essential surgery should be financed early on the path to universal health coverage.

References

1. Essential Surgery | DCP3 [Internet]. [cited 2015 Mar 6].
2. Mock CN, Donkor P, Gawande A, Jamison DT, Kruk ME, Debas HT. Essential surgery: key messages from Disease Control Priorities, 3rd edition. The Lancet [Internet]. 2015 Feb [cited 2015 Feb 8].