Previous studies only looked at whether or not surgery was available.
The new study, which appeared in the Lancet, dug deeper and examined whether patients could access surgery within two hours of travel time, if the surgery services available were adequate, and if patients could actually afford treatment.
The lack of access to surgery could be killing more than malaria, HIV, and tuberculosis combined, with as many as 16.9 million people dying in 2010 alone. This would account for slightly less than one third of all deaths for the year.
Many of these deaths were due to conditions that are easily treatable with surgery, such as appendicitis.
Thus, conditions that might be little more than a nuisance in developed countries could mean an early death for the many billions who lack access.
The results of the study were “outrageous”, according to at least one of the authors, Andy Leather.
Huge gap of access between rich and poor countries
People living in poor countries are far more likely to lack access to surgery. Part of this comes down to the simple mathematics of surgeons per residents.
In the United States there are 36 surgeons per 100,000 people. In contrast, Bangladesh has only 1.7 surgeons per 100,000 people.
In Sierra Leone conditions are even worse. Before the recent Ebola outbreak there were only .1 surgeons per 100,000 people. There may be even fewer surgeons now given that health care professionals are at a high risk of contracting ebola.
Geographically, sub-Saharan Africa is at the most risk, however, south Asia, including Pakistan and Afghanistan, also suffers from a lack of availability.
Researchers estimate that there were nearly 58 million unmet surgery cases in South Asia alone.
Western sub-Saharan Africa recorded over 18.9 million cases. Eastern sub-Saharan Africa added another 17.5 million cases, and southern sub-Saharan Africa added an additional 291,000 cases.
Citizens in Latin America, on the other hand, enjoy higher access to surgery. Central, tropical, and southern Latin America suffered no unmet surgical cases, according to the study.
Surgery is also available to most citizens of the United States and Western Europe. Both regions experienced zero unmet surgical cases.
High mortality rates could cost trillions
Whenever a person dies young, his or her economic contributions will be lost. The same is true of crippling illnesses, with temporary or permanently disabled people unable to fully participate in economic activities.
According to the authors of the report, the unnecessarily high mortality rate created by a lack of access to surgery could cost the global economy as much as $12 trillion dollars between now and 2030.
The researchers have called for $420 billion dollar global investment to combat the lack of access to surgery.
