The 2015 Bangkok Global Surgery Declaration: A Call to the Global Health Community to Promote Implementation of the World Health Assembly Resolution for Surgery and Anaesthesia Care

McQueen, K. A. Kelly; Coonan, Thomas; Derbew, Miliard; Tangi, Viliami; Bickler, Stephen W.; Banguti, Paulin; Gruen, R.; Watters, David

doi:10.1007/s00268-016-3697-5

Cited by 6 publications

(8 citation statements)

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“…In 2015, the Bangkok Declaration encouraged signatories to propagate the Commission’s key messages, promote research on access to safe, affordable and timely surgery, and report on the WHO’s and the Commission’s recommended surgical indicators. 11 Subsequently, Asia-Pacific representatives at the 4th Royal Australasian College of Surgeons (RACS) Global Health Symposium, held in association with the LCoGS in Melbourne in October 2015, resolved to obtain data on the first four of six global surgery metrics for countries in their region.…”

Section: Introductionmentioning

confidence: 99%

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

et al. 2017

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In 2015, the Lancet Commission on Global Surgery (LCoGS) recommended six surgical metrics to enable countries to measure their surgical and anaesthesia care delivery. These indicators have subsequently been accepted by the World Bank for inclusion in the World Development Indicators. With support from the Royal Australasian College of Surgeons and the Pacific Islands Surgical Association, 14 South Pacific countries collaborated to collect the first four of six LCoGS indicators. Thirteen countries collected all four indicators over a 6-month period from October 2015 to April 2016. Australia and New Zealand exceeded the recommended LCoGS target for all four indicators. Only 5 of 13 countries (38%) achieved 2-hour access for at least 80% of their population, with a range of 20% (Papua New Guinea and Solomon Islands) to over 65% (Fiji and Samoa). Five of 13 (38%) countries met the target surgical volume of 5000 procedures per 100 000 population, with six performing less than 1600. Four of 14 (29%) countries had at least 20 surgical, anaesthesia and obstetric providers in their workforce per 100 000 population, with a range of 0.9 (Timor Leste) to 18.5 (Tuvalu). Perioperative mortality rate was reported by 13 of 14 countries, and ranged from 0.11% to 1.0%. We believe it is feasible to collect global surgery indicators across the South Pacific, a diverse geographical region encompassing high-income and low-income countries. Such metrics will allow direct comparison between similar nations, but more importantly provide baseline data that providers and politicians can use in advocacy national health planning.

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Section: Introductionmentioning

confidence: 99%

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

et al. 2017

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“…LCoGS has had a major impact in the past 4 years, achieving a consensus on how to measure the size of the problem presented by lack of access, what needs to be achieved, how to measure surgical and anaesthesia care access, capability, capacity, safety and affordability 22 . In 2015, ASAP through the World Congress of Surgery in Bangkok published the Bangkok Declaration supporting in full the WHA 68/15 resolution and calling on its signatories, representing surgical and anaesthesia colleges and societies across the globe, to support its implementation 23 …”

Section: Advocacy For Universal Access To Safe Affordable and Timelymentioning

confidence: 99%

“…22 In 2015, ASAP through the World Congress of Surgery in Bangkok published the Bangkok Declaration supporting in full the WHA 68/15 resolution and calling on its signatories, representing surgical and anaesthesia colleges and societies across the globe, to support its implementation. 23 Following the iconic moments of 2015the WHA resolution, launch of LCoGS and publication of the third edition of 'Disease Control Priorities' with volume one devoted to Essential Surgery 24 the priority has been to hold national surgical fora, establish national surgical obstetric anaesthesia plans (NSOAPs), to report the recommended six surgical metrics and to conduct research where more information is needed to establish priorities. To coincide with the 70th World Health Assembly in 2017 (a reporting year for the 2015 resolution), WHO published a document on surgical system strengthening 25 that included as one of the global case studies, how Pacific collaboration achieved reporting of the surgical metrics.…”

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confidence: 99%

“…The Presidential Round Table (of College Presidents) has ensured each year between 2013 and 2018 that global surgery topics were discussed, with joint statements issued in 2014 (contaminated wounds), 2015 (support for WHA resolution) and 2016 (the Bangkok declaration and reinforcing the need to report the LCoGS recommended metrics). 23 The former half-day international forum held during the Annual Scientific Congresses a decade ago, has evolved to become a 2-day meeting. The 2014 Singapore congress provided a regional consultation for LCoGS, the 2015 Perth Congress an opportunity to publicize the LCoGS report and in 2016, 12 countries, led by Tonga, in addition to Australia and NZ, presented their first four surgical metrics, a highlight for collaboration in our region between RACS and neighbouring Asia-Pacific countries.…”

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confidence: 99%

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Advocacy for global surgery: a Pacific perspective

Watters

Tangi

Guest

et al. 2020

ANZ Journal of Surgery

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Background The geographic region of the South Pacific covers a third of the globe, much of which is ocean, the world's largest geographic feature, spanning 155 km 2. The ocean expanse is scattered with numerous Pacific Island countries and territories (which fall into three main political groups, whose connections are historical, political and/or economic; Table 1). They represent nations generally with small populations but with the least access to safe, affordable and timely surgery in the world, partly as a result of their geography as well as their stage of economic development. This paper describes how the Royal Australasian College of Surgeons (RACS) and the Pacific region have been involved with global surgery and anaesthesia advocacy since 2012. This has included engagement with the World Health Organization (WHO) in Geneva, their Global Initiative for Emergency and Essential Surgery (GIEESC) and WHO's Western Pacific Region Organization (WPRO). The paper focuses on the Pacific Island countries with which RACS, and the Australian and New Zealand College of Anaesthetists (ANZCA), have established relationships and a history of engagement in supporting local agendas for capacity building. The Colleges engage not only in partnership with universities and health departments, but also collaborates with other Australian and New Zealand specialist medical colleges, and their Pacific or Papua New Guinea (PNG) surgical and anaesthesia counterpart associations (Table 2). Although Timor Leste falls outside of the WPRO, the clinical networks and partnerships established through RACS and the other colleges justify including their role in this account of regional advocacy.

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“…5 The 2015 World Health Assembly resolution 68.15 recommended governments in LMICs to strengthen health systems through improving universal access to emergency and essential surgery. 6 In anticipation of this resolution, LCoGS recommended six metrics to measure timely access, capability, capacity, and affordability. 1,7 The World Health Organization and World Bank have included these indicators of surgical care within their information and monitoring systems.…”

Section: Introductionmentioning

confidence: 99%

Universal access to safe, affordable, timely surgical and anaesthetic care in Papua New Guinea: the six global health indicators

James¹,

Borchem²,

Talo³

et al. 2020

ANZ Journal of Surgery

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Background: The unmet global burden of surgical disease is substantial. The Lancet Commission on Global Surgery (LCoGS) estimated that 5 billion people do not have access to safe, affordable and timely surgical care, with 80% of those without access living in lowand middle-income countries. The Milne Bay Province (pop 331 000) of Papua New Guinea, with an archipelago of islands up to 750 km from its capital, Alotau, has only one hospital capable of performing Caesarean Section, Emergency Laparotomy and managing an open fracture, the three Bellwether procedures. This paper aims to report the six Lancet Commission on Global Surgery metrics for Milne Bay Province. Methods: The study was conducted between January and August 2019. Bellwether access was investigated by a prospective study on 115 patients presenting to hospital. The surgical, anaesthesia and obstetric (SAO) workforce, surgical volume and perioperative mortality rate, were calculated for 2012-2018 from hospital records and operation registers. Financial risk metrics were calculated by surveying 50 patients at discharge from hospital. Results: Bellwether access: Only 27.8% (n = 32) of the study population (n = 115) experienced less than 2-hours second delay (journey time to hospital). The average SAO provider density was 1.8 per 100 000 population. There were 606 procedures performed per 100 000 with a mean annual perioperative mortality rate of 0.3%. Catastrophic expenditure is a risk for 29% of the population. Conclusion: Milne Bay Province can perform surgery safely, but there is limited access to timely surgical care when needed with a significant proportion put at financial risk by requiring it.

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The 2015 Bangkok Global Surgery Declaration: A Call to the Global Health Community to Promote Implementation of the World Health Assembly Resolution for Surgery and Anaesthesia Care

Cited by 6 publications

References 0 publications

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

Collecting data for global surgical indicators: a collaborative approach in the Pacific Region

Advocacy for global surgery: a Pacific perspective

Universal access to safe, affordable, timely surgical and anaesthetic care in Papua New Guinea: the six global health indicators

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