National Audit of Critical Care Resources: How Long Before We Act?(Editorial‪)‬

The estimated annual expenditure on health care is vastly different in the USA (16% of GDP) compared with developing countries (approximately 3% of GDP). (1) South Africa is unique in sub-Saharan Africa, where expenditure on health is relatively high and is estimated to be between 8% and 10%. (1) Despite this, there are serious limitations to many aspects of health care delivery based on multiple factors in South Africa. It may be argued that it will take decades before we outlive the injustices imposed on our society by apartheid. In attempting to offer reasonable and responsible guidance to policy makers and politicians, clinicians and allied health care workers have an obligation to base decisions on objective evidence. To this end, the Critical Care Society of Southern Africa (CCSSA) embarked on a national audit of critical care resources in South Africa. The purpose of the audit was to objectively quantify existing services in the public and private sectors with a view to making recommendations for the future. The work culminated in five papers that were published in the South African Medical Journal. (2-6) In addition, the data were presented to the national and several provincial departments of health, to an audience to which all participants in the study were invited, and to several national and international congresses. The data are compelling and offer a very effective framework on which future plans for critical care may be based. Notwithstanding this, the key recommendations have not been implemented apart from piecemeal implementation strategies by certain provinces. This review is intended to highlight the key observations and to emphasise the sentinel recommendations that the Society believes should be urgently implemented. Study methodology (2)