Ensuring equitable emergency, critical and operative care.

Abstract

Conditions requiring emergency, critical and operative (ECO) care account for a substantial proportion of preventable mortality and disability worldwide, yet ECO systems remain fragmented and underdeveloped in many settings. Recent global policy advances, including the adoption of the World Health Organization (WHO) Global Strategy and Action Plan for Integrated ECO Care by the World Health Assembly, provide an important opportunity to strengthen these systems. However, implementation must prioritise equity. ECO care spans a wide spectrum of complexity and cost, from basic triage, oxygen therapy and essential operations to advanced intensive care and specialised surgery. Given finite resources, health systems should first ensure universal access to foundational ECO care: early recognition of illness, basic airway and oxygen support, essential medications, monitoring, infection prevention, and timely referral. Approaches such as Essential Emergency and Critical Care (EECC) offer a feasible, highly cost-effective minimum standard of care, and prioritising such foundational ECO care is both an ethical imperative and the most effective pathway to achieving equitable population-level health gains.