27 MAY 2019 | Geneva, Switzerland – Delegates to the 72nd World Health Assembly have adopted a resolution on emergency and trauma care aimed at helping countries to ensure timely care for the acutely ill and injured. It is estimated that more than half of deaths in low- and middle-income countries result from conditions that could be treated with prehospital and emergency care, including injuries; infections; acute exacerbations of cancer, diabetes and other noncommunicable diseases; and complications of pregnancy. Effective emergency care systems save lives.
During the discussions, 22 Member States spoke in support of the resolution, which was tabled by the Governments of Ethiopia and Eswatini and co-sponsored by over 30 countries. In their remarks, they praised the sponsoring countries for bringing attention to this area, committed to the recommended actions and requested near-term WHO support for specific activities, including: training for all cadres of health workers, system- and facility-level assessments, implementing standards for essential equipment and processes at each level of the health system, and data collection and quality improvement. They also emphasized the importance of fully integrating emergency care into ongoing universal health coverage planning processes.
“No one should die for the lack of access to emergency care, an essential part of universal health coverage,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We have simple, affordable and proven interventions that save lives. All people around the world should have access to the timely, life-saving care they deserve.”
Recent studies have ranked components of emergency care as among the most cost-effective public health interventions. Strengthening prehospital care by training community-based providers and using staffed community ambulances has been estimated to cost less than US$ 100 per life saved, and has been shown to reduce mortality by 25-50% in some low- and middle-income country contexts.
The World Health Assembly resolution seeks to overcome some of the main challenges facing countries, including poor coordination of prehospital and facility-based care; limited or no coverage of prehospital systems, especially in rural areas; shortage of fixed staff assigned to emergency units; lack of standards for clinical management and documentation; and insufficient funding. In addition, a lack of security for prehospital and facility-based emergency care staff remains a challenge in many countries.
The resolution suggests that all Member States, regardless of available resources, can take steps towards strengthening their emergency care systems. Recommended activities for Member States include creating policies to ensure universal access to emergency care for all; conducting a WHO emergency care system assessment to identify gaps and priorities for action; developing clinical protocols identified in the WHO Emergency Care Systems Framework; and providing emergency care training for all relevant health providers. The WHO Secretariat is invited to expand its technical support to Member States.
In the coming years much of WHO’s support to Member States on emergency and trauma care will be provided through the Global Emergency and Trauma Care Initiative, launched with the AO Foundation in December 2018. The Initiative seeks to rapidly increase capacities to provide quality emergency care in countries and to foster awareness through a global advocacy campaign about its potential to save lives.
Well-organized emergency care is a key mechanism for achieving a range of Sustainable Development Goal targets, including those on universal health coverage, road safety, maternal and child health, noncommunicable diseases, infectious diseases, disasters and violence. It also helps WHO to fulfill the mandate of its Thirteenth General Programme of Work 2019-2023 to strengthen health systems, widen coverage of essential health services and improve integrated service delivery.
WHA report of the Director-General on “Emergency and trauma care”
WHO Emergency and Trauma Care
Global Emergency and Trauma Care Initiative
WHO Bulletin article Improving emergency care in Uganda