The Case for Surgery as an Essential Health Service

Written by Kelsey Christensen

The provision of universal health care is a complex and highly controversial topic both locally and globally. At its simplest, it means ensuring individuals and communities receive the health services they need without facing devastating financial costs. Numerous global organizations including the United Nations, The World Bank, and the World Health Organization have voiced support for universal health care, calling it not a privilege, but a basic human right.

One of the most notable efforts by the international community toward achieving universal health coverage is included in the United Nations 17 Sustainable Development Goals (SDGs), a platform for ending poverty, protecting the planet, and ensuring prosperity for all by 2030. Goal 3, “Good health and well-being” outlines a specific global target for universal health care: “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”. Though “essential healthcare services” is a broad term, the inclusion of surgical and anesthesia services is fundamental to attaining this goal and creating healthy, prosperous communities.  

Surgically treatable diseases affect people at all stages and across nearly every medical discipline, including reproductive, cardiovascular, neurological, and gastrointestinal health. Therefore, surgery is an integral part of establishing health and well-being for all. As the global burden of non-communicable disease continues to rise, UN Member States committed to the Sustainable Development Goals must acknowledge this issue. They must plan for and budget to include surgery, which is an appropriate and cost-effective treatment for a wide range of non-communicable diseases.

In many cases, surgical treatment is not an extraordinary measure, and though surgery requires a significant investment in the health system, the Lancet Commission on Investing in Health estimates that every dollar invested in health has a ten time return in economic growth.  This leads to many downstream benefits to countries who invest in surgery. When the population has access to health services including surgery, they will have a better quality of life, be able to work more productively and attend school, which will lead to a more prosperous country overall. It is a devastating injustice that every day, people around the world are put in the position to choose between basic needs such as food and shelter or medical care. This is why the fight for achieving universal health care, including essential surgical care, must persist.

Including surgery as part of universal health care means making sure that all people can access these treatments. Currently, 33 million people face catastrophic expenditures from seeking surgical care each year. Affordability is one of four components that make surgery accessible, and in our final blog on the Need for Surgery, we’ll cover these four dimensions and how Solidarity Bridge contributes to the sustainable development of surgical accessibility in Bolivia. Stay tuned for our final installment in the coming weeks.

The Catholic Church, the World Health Organization and the United Nations have all named health care as a human right, and national governments and humanitarian groups have responded with improvements in basic care and prevention and treatment of communicable disease. But surgically treatable conditions are responsible for more deaths globally than HIV/AIDS, tuberculosis, and malaria combined. Yet surgery has long been overlooked in the global health community as a luxury too expensive and too complex to prioritize.  

This fall, we are sharing a three-part blog series exploring the need for surgery globally. In our first blog we looked at the global burden of surgically treatable diseases. Above we explore the case for surgery as part of essential health services. Our final blog will focus on key components needed for access to safe and timely surgical care.

Kelsey Christensen, MS is a healthcare professional in the Chicago area with 5 years of experience working in the field of pediatric transplant surgery. She is a recent graduate of Northwestern University’s Master of Science in Global Health program and is currently interning with Solidarity Bridge to learn more about the organization and nonprofit sector work.