Following the resolution to strengthen access to quality emergency, critical and operative care (ECO) services across the globe approved at the Seventy-sixth World Health Assembly, the World Health Organization has announced the Acute Care Action Network (ACAN), a global alliance of key actors and stakeholders committed to saving millions of lives by driving action on ECO through stronger action, together.
ECO services are essential to meet people's health needs across the life course and are an integral part of a comprehensive primary health-care approach. ECO spans from early recognition and first aid in the community, through clinic and emergency unit care, to surgical and anaesthesia services in theatre and beyond. Timely access to ECO services can prevent millions of deaths and long-term impairments from injuries, infections, mental health conditions, acute complications of pregnancy and other health conditions, including in new-borns and children.
Robust ECO services are at the foundation of the ability of countries' health systems to respond effectively to emergency events, and to minimize the danger and impact of acute public health events. The COVID-19 pandemic revealed pervasive gaps in the capacity of ECO services that hindered effective response to COVID-19 and cost countless lives. It has also changed our understanding of health systems and emergency response, and reinforced the need for an integrated and people-centred approach.
"It is the same health system that delivers for both everyday health needs and for emergency preparedness, readiness and response. Whether care is needed for a child with pneumonia, a pregnant woman with bleeding, or the victim of a respiratory virus or an earthquake, only an integrated approach to the full 'ECO' continuum, ensures that health systems can meet people's health needs across the life course AND respond effectively to emergency events," said Dr Bruce Aylward, WHO Assistant Director-General for Universal Health Coverage (UHC), Life Course.
As we come out of the pandemic, we can do better, and we must do more. And we must do it together. The WHA76 resolution on ECO provides an extraordinary opportunity, and ACAN is its cornerstone and force-multiplier, convened to drive strategic engagement of governments, communities, partners, and a range of other stakeholders, for coordinated and high-impact action in countries, with an emphasis on targeted support for implementation of WHO tools in resource-limited settings.
The ACAN is receiving strategic collaboration and support from the Laerdal Foundation and the American Heart Association – two key partners in ECO community. With their support, ACAN and its members will work together to train and support health workers who care for the ill and injured every day; disseminate WHO standards for needed equipment and supplies for ECO delivery at all levels of the health system; strengthen key processes and models of care that drive timely access and continuity, such as triage, resuscitation, effective referral and counter-referral.
ACAN will also promote standardized documentation and data collection in order to understand the reality of ECO delivery and build capacity to use this data to improve quality; engage communities to design ECO interventions that meet their needs; strengthen facility, national and regional planning, and support countries to design governance mechanisms to drive impact; and work to ensure that ECO services are systematically considered and prioritized within packages of services for UHC, as a critical step towards sustainable financing.
ACAN will function as a mechanism for direct capacity building in clinical care, health system planning, and research, and will develop an evidence base to drive effective implementation both within the network and beyond. As part of its initiatives, ACAN will establish the Network Implementation Fund to evaluate and fund proposals for pilot implementation activities in low- and middle-income settings. Additionally, it will coordinate targeted applications for large-scale grant support aimed at sustaining implementation efforts and facilitating outcome-oriented monitoring activities.
