WHO Collaborating Centre at Western University to address international access to surgical care and anesthesia

Researchers at Western University have been tapped by the World Health Organization (WHO) to be the first official Collaborating Centre to study access to safe surgical and perioperative care on the global stage.

In 2016, the 68th World Health Assembly passed Resolution 68.15: “Strengthening of Emergency and Essential Surgical Care and Anesthesia as a component of Universal Health Coverage.” This resolution designated surgery as an emerging pillar, based on the knowledge that five billion people around the world don’t have access to essential life-saving surgery, and 30 per cent of the global burden of disease would be preventable through adequate access to safe essential surgical services like C-sections and orthopedic procedures in trauma.

“The global burden of disease, because of lack of access to surgery, by far outpaces the burden of disease for HIV, malaria and tuberculosis combined,” said Dr. Janet Martin, assistant professor at Western’s Schulich School of Medicine & Dentistry, who is co-leading the WHO Collaborating Centre at Western. “Now it is our responsibility as a collaborating centre to shine the light on this problem. The numbers are staggering.”

The team in the Department of Anesthesia and Perioperative Medicine and the Centre for MEDICI (Medical Evidence-Decision Integrity-Clinical Impact) at the Schulich School Medicine & Dentistry is the first collaborating centre to be designated by the WHO to address this complex surgical and perioperative care problem. They will be working to research the gaps in resources, capacity, infrastructure and training in countries around the globe in order to develop evidence-based priorities toward universal safe and effective essential surgery and anesthesia.

“Often in low-income countries, surgery is considered a luxury. This is very troublesome, and we want to help figure out how we can build capacity in those countries to access emergency and essential surgery,” said Dr. Davy Cheng, Chair-Chief of the Department of Anesthesia and Perioperative Medicine at Schulich Medicine & Dentistry, also a co-lead on the project. “It is a huge honour to be invited by the WHO to be a collaborating centre, and we are looking forward to supporting timely progression towards universal safe and effective essential surgery.”

“The WHO Emergency and Essential Surgical Care Programme is delighted to partner with the Western University MEDICI Centre as an official WHO Collaborative Centre,” said Dr. Walt Johnson, program lead of emergency and essential surgery care (EESC) at WHO. “Worldwide, WHO Collaborative Centres provide technical expertise on issues of vital concern to global health, in this case optimized perioperative care and the delivery of surgical and anesthesia care to the billions of individuals globally that have limited access to safe, timely and affordable surgical care. The MEDICI Centre has been a key partner in the development of Ebola Guidelines for surgical teams and we greatly anticipate important productive collaborative efforts well into the future.”

The MEDICI Centre caught the attention of the WHO after the researchers led a team at WHO Geneva at the height of the Ebola crisis, developing evidence-informed guidelines for surgery and anesthesia care in patients with suspected Ebola infection.

The team also published a landmark paper in the Lancet in 2012. The study examined 21.4 million surgical procedures around the world, and showed that the risk of perioperative mortality has been declining during the past five decades, but only in high income countries. The risk of death after surgery in low and middle income countries has plateaued, and is on the rise in some cases.

Dr. Martin points to what should be routine surgeries like open-fracture reduction, or abdominal emergencies like appendicitis. In lower income countries, the number of surgeons is 10 times less per capita, and even if a patient has access to a doctor who has excellent surgical technique, the hospitals often lack infrastructure and equipment, such as reliable electricity, sterile water and access to anesthetic drugs.

MEDIA CONTACT: Crystal Mackay, Media Relations Officer, Schulich School of Medicine & Dentistry, Western University, t. 519.661.2111 ext. 80387, c. 519.933.5944, crystal.mackay@schulich.uwo.ca @CrystalMackay

Western University delivers an academic experience second to none. Since 1878, The Western Experience has combined academic excellence with life-long opportunities for intellectual, social and cultural growth in order to better serve our communities. Our research excellence expands knowledge and drives discovery with real-world application. Western attracts individuals with a broad worldview, seeking to study, influence and lead in the international community.

The Schulich School of Medicine & Dentistry at Western University is one of Canada’s preeminent medical and dental schools. Established in 1881, it was one of the founding schools of Western University and is known for being the birthplace of family medicine in Canada. For more than 130 years, the School has demonstrated a commitment to academic excellence and a passion for scientific discovery.

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