These gaps cost many their lives—we saw significant avoidable mortality
In Geneva this spring, the World Health Organization formalized what many in global health have long understood: that the absence of emergency care in the world's poorest countries is not a gap to be tolerated but a crisis to be confronted. The Acute Care Action Network, launched at the 76th World Health Assembly with the American Heart Association and the Laerdal Foundation, is an attempt to turn a decade of accumulated tools and protocols into coordinated, on-the-ground action. Nearly 30 million people die each year from conditions that are, in principle, treatable — a reminder that the distance between a medical emergency and a medical system is, for millions, the distance between life and death.
- Low- and middle-income countries bear 4.4 times the acute disease burden of wealthy nations, yet face emergencies with far fewer trained staff, resources, and functioning systems to respond.
- Nearly 30 million deaths annually — roughly half of all global deaths — stem from emergency conditions, with the vast majority occurring where emergency care barely exists.
- The COVID-19 pandemic stripped away any remaining ambiguity, exposing long-standing gaps in critical care capacity that translated directly into avoidable deaths on a massive scale.
- The WHO, American Heart Association, and Laerdal Foundation are now pooling existing tools, training frameworks, and system-design protocols into a single coordinated network rather than parallel, disconnected efforts.
- The network's immediate challenge is translating institutional coordination into sustained, practical change at the clinics and hospitals where people actually arrive in crisis.
This spring in Geneva, the World Health Organization announced the Acute Care Action Network — a coordinated global effort to bring emergency and critical care to low- and middle-income countries where such systems are often absent or overwhelmed. The initiative emerged from the 76th World Health Assembly, backed by the American Heart Association and the Laerdal Foundation, and represents a formal reckoning with a crisis the pandemic made impossible to ignore.
The scale of the problem is difficult to absorb. Nearly 30 million people die each year from emergency conditions — about half of all global deaths — and the burden falls disproportionately on poorer nations, where the acute disease toll is 4.4 times higher than in wealthy ones. A heart attack, a severe infection, a traumatic injury, a complicated pregnancy: these become fatal not because they are untreatable, but because treatment is unavailable when it matters most.
The WHO has spent years developing evidence-based protocols, training materials, and system frameworks for exactly this problem. What was missing was a unified effort to deploy them. The network aims to fill that gap, bringing stakeholder organizations into alignment with a shared focus on vulnerable populations and resource-limited settings. Nancy Brown of the American Heart Association pointed to the pandemic as a turning point that revealed 'significant avoidable mortality and morbidity globally.' Tore Laerdal and WHO Director Rudi Eggers framed acute care not as a specialty concern but as the structural foundation of any functioning health system.
The network's premise is simple: timely emergency care could prevent millions of deaths and cases of long-term disability each year. Whether coordinated institutional commitment can translate into durable change at the level of individual clinics and hospitals — where people arrive in crisis — remains the defining question ahead.
In Geneva this spring, the World Health Organization announced a coordinated push to overhaul how emergency and critical care reaches the world's poorest countries. The initiative, called the Acute Care Action Network, emerged from the 76th World Health Assembly with backing from two major partners: the American Heart Association and the Laerdal Foundation. It represents a formal acknowledgment of a crisis that the pandemic laid bare—that when people in low- and middle-income countries face a medical emergency, the systems meant to save them often simply do not exist.
The numbers tell the story starkly. Nearly 30 million deaths occur each year from emergency conditions alone, accounting for roughly half of all deaths globally. Yet the burden falls unevenly. In low- and middle-income countries, the acute disease burden is 4.4 times higher than in wealthy nations, even as these countries have far fewer resources, fewer trained staff, and less infrastructure to respond. A heart attack, a severe infection, a traumatic injury, a pregnancy complication—these become death sentences not because they are untreatable, but because treatment is not available when it is needed.
The WHO has spent the past decade building a toolkit for this problem: evidence-based protocols, training materials, system design frameworks. What was missing was a coordinated global effort to deploy them. The Acute Care Action Network aims to fill that gap by bringing together stakeholder organizations to work in concert, with particular focus on settings with limited resources and vulnerable populations. The network emphasizes that timely access to emergency care is not a luxury—it is the foundation of whether someone lives or dies.
Nancy Brown, chief executive of the American Heart Association, framed the pandemic as a turning point. The crisis exposed gaps in emergency and critical care capacity that had always existed but were suddenly impossible to ignore. "These gaps cost many their lives," she said. "We saw significant avoidable mortality and morbidity globally." The American Heart Association committed to supporting the network's work by helping to develop, distribute, and evaluate WHO tools and resources in low- and middle-income countries.
Tore Laerdal, executive director of the Laerdal Foundation, echoed the commitment. His organization, which has long focused on training and emergency preparedness, saw the network as a natural extension of work already underway. Rudi Eggers, the WHO's Director of Integrated Health Services, positioned acute care not as a separate concern but as essential to the entire health system. "Robust acute care services are essential to health systems' ability to meet population health needs and to respond effectively to emergency events," he said.
The network's logic is straightforward: timely access to emergency, critical, and operative care could prevent millions of deaths and cases of long-term disability. The conditions it addresses span the full spectrum of acute illness—injuries from accidents, severe infections, mental health crises, acute complications of pregnancy, sudden worsening of chronic diseases. In countries where these services barely exist, the potential impact is enormous. What remains to be seen is whether coordination among organizations can translate into the kind of sustained, on-the-ground change that reaches the clinics and hospitals where people actually arrive in crisis.
Notable Quotes
The pandemic revealed pervasive gaps in capacity of emergency, critical and operative care services. These gaps cost many their lives.— Nancy Brown, CEO of the American Heart Association
Robust acute care services are essential to health systems' ability to meet population health needs and to respond effectively to emergency events.— Rudi Eggers, WHO Director of Integrated Health Services
The Hearth Conversation Another angle on the story
Why does emergency care matter so much more in poor countries than rich ones?
It's not that emergencies are more common there—it's that they're more often fatal. A heart attack in New York has a survival rate measured in percentages. A heart attack in rural sub-Saharan Africa is often a death sentence. The gap isn't biology. It's infrastructure.
But the WHO has had tools for a decade. Why announce a network now?
Having tools and deploying them are different things. A protocol sitting in a Geneva office helps no one. The network is about coordination—getting the American Heart Association, the Laerdal Foundation, and dozens of other organizations to stop working in silos and actually move in the same direction.
What does "timely access" really mean in a place with one hospital for a million people?
It means recognizing that you can't wait for perfect infrastructure. You train the people you have. You build systems that work with what exists. Sometimes it's a phone line to a doctor. Sometimes it's a trained midwife who knows when to refer. Timely doesn't mean fast—it means before it's too late.
The pandemic revealed these gaps. Did they not exist before?
They existed. The pandemic just made them impossible to ignore. When hospitals everywhere were overwhelmed, the ones that were already barely functioning simply collapsed. It forced the world to see what had always been true.
What happens next? How does a network actually save lives?
That's the real test. It's easy to announce. Harder to sustain. The network has to move money, training, and attention to places where they're needed most, and keep doing it year after year. The first year will show whether the partners are serious.