TL;DR:

• 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

Impact:

• 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:

More implementation:

• Developing the EECC training course and cascading this to health workers across LMICs
• Implement global and national EECC plans

More advocacy:

• 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

More research:

• 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!