- We can make saving lives more cost-effective in low and middle income countries
- By providing the "EECC package" of 40 life-saving actions that are often overlooked - and has an estimated cost-effectiveness of $17 USD per DALY
- With advocacy, research and implementation (such as training health workers)
- Fund us please!
- And talk to us about how we can do better fundraising, communications and advocacy
Background info about EECC
Essential Emergency and Critical Care (EECC) is the basic, cost-effective care that all critically ill patients in the world should receive. The EECC package consists of 40 fundamental life-saving actions that are often overlooked (such as providing oxygen and fluids) and is designed to be feasible in low resource settings. EECC can reduce preventable deaths at scale, in all ages and many medical conditions. The highest yield is expected in low and middle income countries (LMICs). Modeling suggests that providing EECC globally could save one million lives per year. The EECC Network, established in 2021, is made up of 300 global experts and clinicians advocating for EECC, working across more than 50 countries. EECC is not for profit.
What we advocate for and why we think it’s a good idea in theory
Essential care for critically ill patients
Rather than expensive drugs and high-tech machines, we focus on simple interventions such as oxygen, fluids and vital signs checking (which are really cheap and life-saving and often overlooked).
Why don’t health providers do this already?
- Donors often focus on high-tech solutions since they attract attention
- For example, during the COVID-19 pandemic, some donors from high income countries prioritized sending expensive high-tech equipment like advanced ventilators to low resource settings rather than ensuring the provision of low-cost, life-saving care, such as oxygen (ventilators without oxygen are useless or even dangerous. Providing oxygen can save many lives for the same cost of one ventilator)
- Healthcare evolves in silos of medical specialties or diagnoses, so HIV, TB, malaria diagnostics and treatments may receive lots of funding while basic equipment and diagnostics for other life-threatening conditions are neglected
- A common perception is that the basics of healthcare (e.g. taking vital signs and acting on warning signs) is already being done - but recent research shows that it’s not
Our successes so far
- Reached a global consensus among experts on the life-saving actions that constitute EECC
- Promoted the uptake of EECC, which has been adopted by the Tanzanian Ministry of Health as national policy
- Established strong links and ongoing collaborations with the WHO, the World Bank and UNICEF
- The international NGO, MSF (Doctors Without Borders) has adopted EECC as policy
- We created a global EECC Network of 300 expert clinical champions in 50 countries around the world
- The EECC Network’s Training Working Group is developing a manual, resources and training curricula for clinicians worldwide
Research and Publications:
- The rationale behind EECC
- Global expert consensus on the 40 life-saving actions that make up EECC and the resources required for delivering this care
- There is a large burden of critical illness in hospitals: 12-18% of all hospitalized patients are critically ill, with a mortality rate of 15-30%
- EECC delivery has substantial gaps:
-In Malawi, 89% of patients who need oxygen do not receive it
-In Tanzanian hospital wards, 44% of resources required for EECC are missing
- Providing EECC to a critically ill patient costs 17 USD per day in Tanzania
- The cost-effectiveness of EECC is 16 USD/ DALY (i.e. 16 USD per healthy life year gained)
- The potential (modeled) impact of EECC is 1 million lives saved globally each year
- EECC is a priority for health systems globally
We are looking for funding for our 2023 plans
So that we can do:
- Developing the EECC training course and cascading this to health workers across LMICs
- Implement global and national EECC plans
- Advocating for more hospitals implementing EECC, more countries adopting EECC as a national policy
- An EECC Champions Training and Advocacy Workshop 2023
- Improved Communications and Advocacy, needing expertise and interns
More meta advocacy:
- Expand the EECC Network, get more members and people advocating for EECC
- Strengthen the Network governance, to include working groups and national hubs
- Find more cost effective ways to save critically ill patients in resource constrained settings through clinical trials, implementation research, improved modeling and health economic analyses
Call to action
- Fund our 2023 plans
- Advise us on how to do better fundraising, communications and advocacy - be our expert advisor or intern with us if you have these skills!
- If you are interested in EECC and/or providing care to critically ill patients - join the EECC Network! :)
Posted by Alexandra Wharton-Smith and Carl Otto Schell. Thanks to Yonatan Cale for helping us write this post!
A cost-effectiveness estimate of EECC in Tanzania has just been published. Using Covid-19 as a tracer condition, EECC has an incremental cost-effectiveness ratio (ICER) of USD 14 /DALY when compared to current district level hospital critical care. https://link.springer.com/article/10.1007/s41669-023-00418-x
Wow, this sounds really promising! Where does this $16 per DALY averted figure come from?
Thank you, I agree it is promising!
The figure "$16 per DALY " comes from Wellcome Trust funded research. The manuscript is currently under peer-review. The setting is district hospital level care in Tanzania.
Thanks - I expect potential EA donors will want to take a closer look at that research once it's publicly available, to understand exactly which costs and effects are included in that estimate, as well as the extent to which it has external validity (i.e. how likely it is to apply to other settings).
Also, I guess the cost-effectiveness of funding the EECC Network itself isn't $16 per DALY averted - this would depend on the impact of your work, and would need estimating separately.
Yes, the estimated cost effectiveness of 16 USD/ DALYS is for implementing EECC in Tanzania. A link will be set up as soon as the manuscript is published.
The EECCnetwork has been established to facilitate advocacy, implementation and research around EECC. The vision is to reduce/stop deaths that can be prevented by the low-cost, feasible lifesaving care that makes up EECC. The EECCnetwork needs funding to deliver on this, but the cost-effectiveness of such support is, as yet, unknown.
Anyone with questions is most welcome to reach out us!
Hot from the press: " Essential emergency and critical care as a health system response to critical illness and the COVID19 pandemic: what does it cost?".
Published today in the scientific journal Cost Effectiveness and Resource Allocation.