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Annual Report 2021/22

President’s Letter

The last two and a half years have been difficult but anaesthesiologists, WFSA and our partners have risen to the challenges thrown up by the COVID-19 pandemic. This review highlights just some of the ways we’ve been able to do that. The WFSA is a federation, we are our member societies. We can achieve so much by working together. We value your commitment to improving patient care and working with us to achieve our vision of universal access to safe anaesthesia.

WFSA in numbers

Cover image courtesy of Dr Vanessa Silva Ramirez. This report outlines WFSA's activities from August 2021 - July 2022

01. Education

WFSA’s internationally renowned clinician-led training and education programmes are a proven means of improving the skills and competencies of thousands of anaesthesia professionals.

Led by in-country faculty and tailored to the local context, WFSA programmes provide practical training and knowledge to clinicians across a wide range of anaesthesia, perioperative and pain management specialities.

The pandemic has severely limited traditional face-to-face training programmes. Ensuring these valuable training opportunities are not lost has been at the centre of WFSA’s efforts to create accessible and interactive e-learning programmes and re-establish in-person courses.

Safer Anaesthesia From Education (SAFE)

The Safer Anaesthesia From Education (SAFE) programme provides obstetric or paediatric anaesthesia training to anaesthesia professionals working in low-resource settings.

SAFE is a practical, hands-on course employing skills sessions, discussion and low-fidelity simulation to develop the types of skills and knowledge needed by anaesthesia professionals working in low-resource settings.

In 2021 - 2022

In 2021, WFSA launched the SAFE Online platform and conducted successful pilots for SAFE Online Obstetrics in Uganda and SAFE Paediatrics in India, Cambodia and Japan. WFSA also partnered with Mercy Ships to deliver the first hybrid SAFE Obstetrics courses in Liberia, training over 70 anaesthesia professionals.

In the last year, WFSA and our partners introduced SAFE training in Somaliland and Japan and trained over 200 anaesthesia professionals globally.

2022 and beyond

With COVID restrictions lifting we’ll be expanding the programme to new regions, piloting a new SAFE Paediatrics – Cleft course, launching SAFE Online Paediatrics and translating course materials into French and Spanish.

10 Years of SAFE

In 2021, the SAFE community celebrated the 10th anniversary of the first ever SAFE Obstetrics course.

Since its launch in Uganda in 2011, SAFE has trained over 6000 clinicians and developed over 1000 clinical instructors across 50 countries.

“With 30 anaesthesia providers from 15 different hospitals, the SAFE course participants accounted for around half the anaesthesia providers in Somaliland.”

– Dr Larissa Latif, SAFE Trainer, SAFE Obstetrics Somaliland 2022

WFSA Fellowship Programme

WFSA Fellowships offer anaesthesiologists from low-resource settings the opportunity to undergo sub-speciality anaesthesia training or non-clinical training at another medical institute.

Since its launch in 1996, the programme has trained over 400 fellows from over 60 countries. Fellowships encompass eight clinical sub-specialities as well as research, medical education and simulation-focused placements.

Alongside providing high quality training, the programme seeks to develop the next generation of anaesthesia leaders and educators. Upon returning home, WFSA fellows pass on their new expertise and learning to their colleagues and ultimately improve their local anaesthesia services.

2022 and beyond

The WFSA Fellowship Programme will be expanding back to a truly global programme following pandemic-related disruptions. An early example of this is the re-establishment of a Paediatric Anaesthesia Fellowship at BARTC in Bangkok, Thailand.

WFSA Scholarship Programme

WFSA’s scholarship programme provides vital opportunities for young anaesthesiologists from low- and middle-income countries. This means they can attend the international and regional congresses that would normally be out of reach to them.

Attendance at these congresses enables young anaesthesiologists to improve their knowledge and skills, build up their professional networks, and present research. Since its launch in 2008, the programme has supported over 750 anaesthesiologists from WFSA member societies to attend international and regional congresses.

In 2021-2022

In 2021, 483 scholarships were awarded to anaesthesiologists from 69 Member Societies to attend the 17th World Congress of Anaesthesiologists (WCA). This represented both the largest number of WFSA Scholars and the greatest participation of colleagues from low-and-middle income countries at any single anaesthesia meeting.

“The WCA was an eye opener. The lectures were informative, evidence-based, topical and so relevant. Thank you for an amazing experience!”

– Dr Charme van Tonder, South Africa

Liberia Anaesthesia Capacity Development Programme

In 2018, Liberia - a country with a population of 5 million - had no home-grown physician anaesthesia professionals.

To address this chronic shortfall in anaesthesia provision, the Liberia Anaesthesia Capacity Development Programme was created to support Liberian physicians to complete the West African College of Surgeons (WACS) Diploma in Anaesthesia through training in Kano, Nigeria. The project is a partnership with the Liberian Medical and Dental Association, the Nigerian Society of Anaesthetists and the Aminu Kano Teaching Hospital.

Despite the challenges posed by the pandemic, three physicians have received their WACS diplomas. Two of the physicians have so far returned to continue their practice in Liberia whilst one has stayed in Nigeria to continue training to complete the WACS membership qualifications.

In 2021 - 2022

The Liberia Anaesthesia Capacity Development Programme continues to be the only initiative that addresses the shortfall of physician anaesthesia professionals in Liberia. In 2022, the programme welcomed a new diploma candidate. WFSA continues to seek funding for more training opportunities.

“By specializing in anaesthesia, I shall endeavour along with my colleagues to ensure medical students in Liberia consider anaesthesia. I look forward to being able to build the capacity of our anaesthetist nurses. I want to increase the strength of the anaesthesia workforce within the country so that as many as patients as possible can benefit from safe anaesthesia.”

– Dr Kpehe Jig Maimie, Liberia

Dr Maimie (right) with the then Head of Department, Dr. Salahu, following a cochlear implant surgery.

Digital Learning Resources

Anaesthesia Tutorial of the Week (ATOTW)

Over 475 tutorials, published in English, Spanish, Portuguese, French and Chinese, are available to download from the ATOTW virtual library.

Update in Anaesthesia (UIA)

In 2021/22, UIA’s library of over 600 downloadable articles was accessed over 71,000 times.

Anesthesia & Analgesia

In 2021, A&A published a range of open access global anaesthesia articles on issues as diverse as Anesthetic-Related Critical Incidents from the South African Paediatric Surgical Outcomes Study to Caesarean Delivery and Neonatal Outcomes in China.

WFSA YouTube

Following the success of the virtual World Congress of Anaesthesiologists in 2022, the 100 most popular WCA lectures and presentations have been uploaded into playlists organised by specialism. These films appear alongside the popular series of subtitled educational videos on adult and paediatric anaesthesia produced in partnership with Southampton Hospital.

02. Advocacy

WFSA engages with key decision-makers to advance the availability, safety and quality of anaesthesia and perioperative services worldwide.

We amplify the voices of anaesthesiologists at the local, national, regional and global levels to advocate for anaesthesiology and surgery as an essential element of global health.

As the only global federation of anaesthesiologists, WFSA is in official relations with the World Health Organization (WHO) and has consultative status with the United Nations Economic and Social Council (ECOSOC).

Unity – Access – Safety

WFSA’s advocacy efforts are guided by three pillars:

Advocating on the Global Stage

As a non-state actor in official relations with WHO and consultative status with ECOSOC, WFSA actively engages with UN bodies and their member states to advocate for policies and investments which will strengthen our members’ ability to provide safe and accessible anaesthesia services. We represent our member societies and the wider anaesthesia community at WHO’s regional and global meetings.

In 2021/22, WFSA participated in seven WHO meetings, presenting 12 statements across a range of global health issues including:
  • Professional well-being
  • Global action on patient safety
  • National anaesthesia plans
  • Global strategy for digital health
  • Pandemic preparedness and health emergency (watch video below)

“In the quest for equity and justice through health, WFSA stands tall. Its constant push for technical excellence, matched equally by the strength of its voice advocating for the most vulnerable.”

– Dr Ruben Ayala, G4 Alliance Permanent Council President

The Global Anaesthesia Workforce Map

This internationally renowned research project maps the number, distribution, and training of anaesthesia professionals globally. With data obtained from 153 countries representing 97.5% of the world’s population, the workforce map provides the most comprehensive dataset of the global anaesthesia workforce ever compiled.

The WFSA Global Anaesthesia Workforce Map evidences the acute shortage of anaesthesia professionals worldwide and highlights the gap between the rich and poor countries. Based on current population data, more than 136,000 additional physician anaesthesia professionals are needed immediately to achieve an interim target density of 5 per 100,000 population in all countries. Research findings published in the journal Anesthesia & Analgesia. This article has been cited over 190 times.

The survey is widely utilised by policymakers and public health practitioners to better understand the global anaesthesia workforce and to advocate for improved anaesthesia resourcing worldwide.

In 2021/22

Stakeholders in 194 countries have been contacted to supply anaesthesia workforce data for an updated workforce survey. An analysis is currently being conducted which will be published in a peer-reviewed journal in 2023.

Global Days of Action

WFSA works with its member societies and other global health stakeholders to provide a united global advocacy voice for anaesthesia.

World Anaesthesia Day

World Anaesthesia Day commemorates the birth of anaesthesia on 16 October 1846 when doctors demonstrated the use of ether for the first time on a patient.

Despite nearly 170 years having passed since that first anaesthetic procedure and the countless breakthroughs that have succeeded it, nearly 5 billion people around the world continue to lack access to safe anaesthesia.

Global awareness days like World Anaesthesia Day are a powerful advocacy tool to mobilise political will, educate the general public and highlight the achievements of the global anaesthesia community. Every year on 16 October WFSA supports anaesthesia professionals all over the world to celebrate their profession and have fun whilst doing it.

In 2021 - 2022

World Anaesthesia Day 2021 focused on the theme of ‘Teamwork: Stronger team for better patient care’. WFSA launched a #TeamAnaesthesia social media campaign to celebrate the multidisciplinary skills and attributes of clinical teams. A campaign toolkit that included a photo booth, videos, flyers and training materials was developed and disseminated to member societies and the wider global anaesthesia community.

15 World Patient Safety Day

As an active member of the World Patient Safety Network, WFSA celebrates World Patient Safety Day on 17 September by calling for global solidarity and concerted action by governments and international partners to improve patient safety.

In 2021 - 2022

World Patient Safety Day 2021 focused on the need to prioritize and address safety in maternal and newborn care, particularly around the time of childbirth. This topic aligned with WFSA’s successful efforts to embed wording on anaesthesia into a Human Rights Council Resolution on Preventable Maternal Morbidity and Mortality.

03. Safety & Quality

Safety and quality are essential components of improving anaesthesia care globally. WFSA works with its partners to share good practice, improve access to essential training and equipment, and build the evidence base to enable anaesthesia professionals to practice safe anaesthesia that meets the needs of patients the world over.

Utstein Surgical Indicators

In 2019, in partnership with the Laerdal Foundation, WFSA convened at meeting at Utstein Abbey in Norway to review and develop metrics and reporting criteria for surgery, anaesthesia and obstetrics (SOA). This was the first comprehensive review of the six. To undertake the first comprehensive review of the six indicators developed by The Lancet Commission on Global Surgery.

The 36 invited global experts refined the existing indicators down to five - surgical volume; geospatial access; workforce; perioperative mortality; and catastrophic expenditure.

In 2021 - 2022

The consensus reached at the Utstein Conference, which included refined indicators, approaches to data collection and reporting criteria necessary for patient safety, was published in PLoS Medicine. Now in its implementation state, five multidisciplinary working groups are creating a ‘How To’ manual for practitioners and policy-makers to define data collection approaches for each of the five indicators.

2022 and beyond

A follow-up Utstein conference in September 2022 will plan for the piloting of the manual in 2023. Next steps will be to integrate the indicators and manual into national and regional data collection processes, and to facilitate and encourage their use at national, regional, and global levels.

WFSA is a co-founder and partner of Lifebox, a global non-profit organisation working to improve the safety of surgery and anaesthesia in low- and middle-income countries. Lifebox looks to improve anaesthesia safety, reduce surgical infection rates, and strengthen surgical teamwork through tools, training, and partnerships.

Working in partnership with anaesthesia professionals across the globe, Lifebox has distributed more than 32,000 pulse oximeters, supported by 280 workshops.

2022 and beyond

“Capnography for Cleft” is a new joint programme with Smile Train which is building on the work of WFSA’s Minimum Capnometer Specifications to develop a robust, affordable capnography device suitable for low-resource settings.

Anaesthesia Innovation Awards

The WFSA Fresenius Kabi Anaesthesia Innovation Awards programme identifies and supports the development of innovations that have the potential to transform the field of anaesthesia and improve patient safety worldwide.

Winners screened promotional films about their innovations at special sessions of the World Congress of Anaesthesiologists 2021.

“Our primary vision is to save lives in operating theatres worldwide. This award provided us with much needed funds for critical product development, specifically in the areas of optimizing sensor accuracy, refinement of the app and its user interface, and shrinking the device footprint”

– 2019 Innovation Award winner, Dr Paul Barton

The Screenless Anaesthesia Monitor (SAM)

04. Working Together

A Global Federation

Our members are our strength. As the foremost global network of anaesthesiologists, we draw together the expertise and knowledge of hundreds of thousands of anaesthesiologists in our 133 member societies in over 140 countries.

Our members’ diversity and global reach makes WFSA a unique organisation, leading the way in promoting safe anaesthesia and perioperative care on a global scale.

Through our programmes, WFSA works for and on behalf of our members to share their expertise, facilitate their leadership and strengthen their efforts to improve anaesthesia provision.

World Congress of Anaesthesiologists

Dubbed the ‘Olympics of Anaesthesia’, the World Congress of Anaesthesiologists (WCA) is the pre-eminent international congress for anaesthesiologists.

In 2021/ 2022

In 2021/ 2022 The 17th WCA took place from 1 - 5 September 2021 and was attended by 6557 delegates from 152 countries. Originally planned to be hosted in Prague, Czech Republic, COVID-19 restrictions forced the congress to become the first fully virtual WCA. WCA2021 realised an ambitious scientific programme that featured 504 different presenters giving 643 presentations over 200 sessions. To ensure this learning isn’t lost, the 100 most popular sessions and seminars are now available on the WFSA

Bringing together thousands of specialists from around the world, the WCA provides an extraordinary opportunity for the promotion of science, education, training, networking, and the exchange of experience across the spectrum of anaesthesiology. Alongside the 25-track scientific programme, a series of interactive Meet the Expert sessions and Problem-Based Learning Discussions (PBLD) enabled delegates to discuss clinical scenarios based on 10 different specialty areas. Over 1400 abstracts were accepted and presented during the live event. This wealth of new research is available in a special WCA 2021 Abstract Book published in Anesthesia & Analgesia.

In keeping with WFSA’s role of uniting anaesthesiologists worldwide, WCA2021 enabled delegates to build their own personal and professional networks through a range of interactive platforms, including a Global Anaesthesia Village, SpatialChat, and Prague City Square.

Reflecting our members’ interest and engagement with industry partners, WCA 2021 hosted 14 focused industry symposia sessions on issues ranging from non-invasive monitoring to the training needs of obstetric surgeries.

WFSA supported 583 scholars from low, lower middle-income, and upper middle-income countries to attend WCA2021. The support of generous donors meant that this was the largest number of scholarships offered by WFSA for any WCA.

2022 and beyond

The 19th WCA will take place in Singapore from 3 – 7 March 2024. It will be the first in-person world congress since 2016, enabling the global anaesthesia community to renew and reaffirm the professional and social connections which form the bedrock of global anaesthesia.

Keep up-to date on WCA2024 announcements at wca2024.org

Find out more on wca2024.org

05. Partnerships & Finance

Global Impact Partners

WFSA Fellowships offer anaesthesiologists from low-resource settings the opportunity to undergo sub-speciality anaesthesia training or non-clinical training at another medical institute. WFSA works with Global Impact Partners to deliver anaesthesia patient safety programmes at scale. Our current Global Impact Partners are Laerdal Foundation, Masimo and most recently, Johnson & Johnson. The impact of these partnerships has been far-reaching, with significant contributions being made to health system strengthening in Bangladesh, Kenya, India, Nepal, Tanzania and Zimbabwe.

  • Laerdal Foundation: WFSA’s six-year relationship with the Laerdal Foundation has delivered training for anaesthesia professionals in Tanzania, Zimbabwe, Bangladesh, Nepal, and India. Through the ‘Better Births – Safer Births’ initiative, anaesthesia professionals were trained in obstetric anaesthesia through Safer Anaesthesia From Education (SAFE) and Vital Anaesthesia Simulation Training (VAST) courses.The Laerdal Foundation continues to support the Utstein Metrics Initiative which is working on the development and subsequent adoption of refined global surgical indicators.
  • Masimo: Utilising strong links with the Indian Society of Anaesthesiologists, the WFSA partnership with Masimo has sought to strengthen anaesthesia capacity in India by training 900 clinicians and 142 medical educators through a range of WFSA-led programmes. In addition, the partnership has supported scholars to attend regional and global congresses including the 2021 World Congress of Anaesthesiologists. This successful partnership continues with a new project focused on ways to strengthen anaesthesia capacity in Palestine.
  • JOHNSON & JOHNSON: Following the success of the Obstetric Safe Surgeries programme in Kenya, Johnson & Johnson is supporting a new three-year project to strengthen anaesthesia and surgical services in Kenya and Malawi. In Kenya, the programme will focus on improving obstetric fistula services. In Malawi, the focus will be on long-bone fracture.

Our Partners

Support from these organisations has enabled the WFSA to expand our vital education and training programmes around the world. We thank these partners for their continued financial support and dedication to safe anaesthesia and global health.

Finance

Return on Investment

The WFSA is supported by an extraordinary network of thousands of volunteers. They generously and graciously dedicate their expertise and time to our work year on year.

Experienced trainers volunteer their time and expertise to join WFSA’s committees, council and board as well as design and run our training programmes. The in-kind value of this volunteered time and expertise is conservatively estimated to be over $4million per year.

This support means that WFSA provides a return of over $10 for every $1 invested in the organisation by its membership.

Our volunteers are the foundation of what we do, and we could not succeed without them.