Safety in Anaesthesia (In THEIR Opinion) (Report‪)‬

The Safe Surgery Saves Lives initiative of the World Alliance for Patient Safety of the World Health Organization (WHO) (World Alliance for Patient Safety 2008) is one of the most important steps towards improving the safety of patients undergoing surgery since the Institute of Medicine's report 'To Err is Human' (Kohn et al 1999) called for urgent action on iatrogenic harm. The pursuit of health, defined as: 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (World Health Organization 1946) depends on a social structure which includes an absence of war, adequate supplies of food, and respect for human rights (including those of women and children) (United Nations 1997). It also depends on the traditional pre-requisites for public health--control of infectious disease and safe childbirth for example. Surgery has perhaps been seen as less critical, expensive, and something of a luxury in the context of the priorities in many countries. However, work undertaken as part of this initiative has identified access to surgery as more important than previously realized. It has been estimated that about 11% of the global burden of disease arises from conditions amenable to surgical treatment (Debas et al 2006). It turns out that about 234 million operations are undertaken around the world every year, which is actually more than the number of babies born (Haynes et al 2009). Unfortunately, these operations are not evenly distributed: only 3.5% serve the needs of the 34.8% of the global population who live in countries spending $100 or less per person on healthcare, while 58.9% are performed on the 15.6 % who live in countries spending over $1000.