In Response

In Response We thank Dr Sund1 for his interest in the proposed Anesthesia Training Framework of the World Federation of Societies of Anaesthesiologists (WFSA), and we agree entirely that a team effort is needed to address the global anesthesia workforce crisis. Our article provides a starting point for discussion on the best way to scale up the anesthesia workforce, and we encourage all stakeholders to engage in the process. We acknowledge and applaud the role of faith-based institutions in training and quality health care delivery. The vision of the WFSA is “universal access to safe anesthesia care,” and we are working toward this in partnership with organizations and individuals who share our vision without discrimination against religion, gender, age, or color. To give just one example, the WFSA partners with Christian Medical College in Vellore, India, to offer subspecialty training programs in pediatric anesthesia and intensive care medicine for anesthesiologists from low-resource countries in Asia and Africa.2 The hospital treats people of all colors and creeds, and we apply the same ethos to our educational activities. Burundi, where Dr Sund1 works, has a population of 11.5 million people served by 6 anesthesiologists and approximately 330 nonphysician anesthesia providers.3 A recent study showed that a physician anesthesia provider density of 4/100,000 population is associated with a steep decrease in maternal mortality4; this would equate to >400 physician anesthesia providers in Burundi. It is clear that the work being done by Dr Sund1 and his colleagues is highly needed. Our article contains a challenge: anesthesiologists need to take a leading role in workforce development and work with others to provide solutions. The proposed Anesthesia Training Framework provides a tool for the structured development of a locally appropriate quality anesthesia workforce. We need input during Anesthesia Training Framework development and implementation from anesthesiologists everywhere, including those providing essential anesthesia care in rural faith-based hospitals. Wayne Morriss, MBChB, FANZCAWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomDepartment of AnaesthesiaUniversity of OtagoChristchurch HospitalChristchurch, New Zealand[email protected] Andrew Ottaway, BMBS, MPH, FANZCAHobart Anesthetic GroupHobart, Tasmania, AustraliaUniversity of Tasmania School of MedicineHobart, Tasmania, Australia Miodrag Milenovic, MD, PhDWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomClinical Center of SerbiaEmergency Center, Center for Anaesthesiology and ResuscitationUniversity of BelgradeSchool of MedicineBelgrade, Serbia Julian Gore-Booth, MAWorld Federation of Societies of AnaesthesiologistsLondon, United Kingdom Carolina Haylock-Loor, MDWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomServicio de AnestesiaCuidados Intensivos y Unidad de DolorHospital Del ValleSan Pedro Sula, Honduras Bisola Onajin-Obembe, MBBS, FWACS, MBAWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomDepartment of AnaesthesiologyCollege of Health Sciences, University of Port HarcourtRivers State, Nigeria Gonzalo Barreiro, MDWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomMontevideo, Uruguay Jannicke Mellin-Olsen, MD, DPHWorld Federation of Societies of AnaesthesiologistsLondon, United KingdomDepartment of AnaesthesiaIntensive Care and Emergency MedicineBaerum Hospital, Sandvika, Norway