Anesthesiology Leadership in Global Health Security: Strengthening Perioperative Governance and Resilience

To examine the gap between expanding access to surgery and the development of safe, resilient perioperative systems, and to consider the contribution of anesthesiologists to multidisciplinary governance for global health security. The Surgical Preparedness Index, measured across 1,632 hospitals in 119 countries, was positively associated with maintenance of planned surgical volume during the COVID-19 shock. Observational studies from Africa have reported substantial postoperative complication and mortality rates, including failure to rescue, that is, death following a potentially treatable postoperative complication in which clinical deterioration is not recognized or managed in time. Workforce shortages, essential drug disruptions, and pandemic experience further demonstrate the need for coordinated perioperative planning. Direct evidence on the effect of anesthesiology leadership interventions nevertheless remains limited. The currently available evidence suggests that the consistent inclusion of anesthesiologists in multidisciplinary decision-making bodies may contribute to safer perioperative care, more effective workforce management, better use of resources, and improved emergency readiness. Such involvement should complement, rather than replace, the leadership roles held by surgeons, intensivists, nursing managers, hospital administrators, and public health specialists.