Equity Through Anesthesia

Global Productivity Loss of $800 Billion Annually

There is currently staggering inequity in access to surgery and anesthesia around the world. The Lancet Commission on Global Surgery estimated that 5 billion people lack access to safe, affordable, surgical and anesthesia care. An additional 143 million surgeries are needed each year to save lives and prevent disability.1

That means that in the time since this page loaded, 0 surgeries were needed and didn't happen.

The Commission concluded that between the publication of its findings in 2015 and the year 2030, that gap would cost the world $12 trillion in lost productivity if nothing were done to address it, an average of $800 billion per year.

The causes of this healthcare gap are complex, yet because general anesthesia is the foundation for surgery around the world, curing limitations associated with the delivery of anesthesia may be core to finding broad solutions. Current anesthesia limitations involve inequities in workforce distribution, limitations in equipment and infrastructure availability, and logistical hurdles to basic healthcare access. Additionally, innovation in the underlying anesthetic drugs upon which surgeons rely has been anemic for over half a century because of drug development roadblocks in the underlying science.

Imagine if the entire United States had only 80 anesthesiologists. That's what it's like to live in Ethiopia, where fewer than 25 physicians with an anesthetic qualification serve 99 million people.2

Significant change leading to more equitable access will require new approaches. One possible area for innovation is in inhaled general anesthetics (IGAs), which are foundational to the practice of general anesthesia and therefore most major surgery. All current IGAs can cause significant and potentially life-threatening side effects including cardiovascular and respiratory depression3,4, post-operative nausea and vomiting5, emergence delirium6, post-operative cognitive dysfunction7, and more. In high-income countries like the U.S., healthcare systems spend many tens of billions of dollars to mitigate these side effects.

New IGAs with fewer side effects could substantially lower these side effect mitigation costs in high-income countries. New, safer drugs may also allow for disruptive change in how and where anesthesia is delivered, improving clinical outcomes with existing resources and expanding access. Expanesthetics is working to develop just such drugs — new IGAs with the potential to unlock a paradigm shift in the practice of general anesthesia. This could significantly contribute to improving equity and access to surgical and anesthesia care.

A revolution in global surgery

In addition to its world-leading technology, Expanesthetics has assembled a team that includes globally recognized experts in anesthetic drug development and clinical practice as well as a Board of Directors with experience running multibillion-dollar, global-scale organizations. Leading international commercial anesthetic companies have expressed interest in partnering with us after we achieve first-in-human data. Work to date has been financed with $8 million by nearly a hundred individual anesthesia providers in the United States who believe in the potential success of Expanesthetics’ approach.

Expanesthetics now has a clear roadmap for screening a selection of anesthetic candidates in a series of in vitro and in vivo research studies to identify a top candidate for advancement into first-in-human trials. Early research provides compelling proof-of-concept rationale for success. Surveys of the historical scientific and current commercial environment help quantify the risk the project faces as well as the potential for financial success and philanthropic impact.

The risk and capital requirements for the next stage of research are too high for traditional capital sources such as angels, VCs, grants, and public company partners. Yet, there is a path forward. Experts describe companies with unproven business models like Expanesthetics as ideal candidates for philanthropic impact investment.8

1. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet Comm. 2015;386(9993):569–624.

2. World Federation of Societies of Anaesthesiologists (WFSA) Workforce Map.

3. Steffey MA, Brosnan RJ, Steffey EP. Assessment of halothane and sevoflurane anesthesia in spontaneously breathing rats. Am J Vet Res. 2003 Apr;64(4):470–4.

4. Brosnan RJ, Steffey EP, LeCouteur RA, Imai A, Farver TB, Kortz GD. Effects of ventilation and isoflurane end-tidal concentration on intracranial and cerebral perfusion pressures in horses. Am J Vet Res. 2003 Jan;64(1):21–5.

5. Gan T, Sloan F, Dear G de L, El-Moalem HE, Lubarsky DA. How much are patients willing to pay to avoid postoperative nausea and vomiting? Anesth Analg. 2001 Feb;92(2):393–400.

6. Lim BG, Lee IO, Ahn H, Lee DK, Won YJ, Kim HJ, et al. Comparison of the incidence of emergence agitation and emergence times between desflurane and sevoflurane anesthesia in children: A systematic review and meta-analysis. Medicine (Baltimore). 2016 Sep;95(38):e4927–e4927.

7. Zou Y-Q, Li X-B, Yang Z-X, Zhou J-M, Wu Y-N, Zhao Z-H, et al. Impact of inhalational anesthetics on postoperative cognitive function: Study protocol of a systematic review and meta-analysis. Medicine (Baltimore). 2018 Jan;97(1):e9316–e9316.

8. The Bridgespan Group. “Philanthropy’s New Frontier.” Available from:

* This is not an offer to sell or a solicitation of any offer to buy any securities. Offers are made only by prospectus or other offering materials. Only prospective investors who have been invited to review such materials and meet the suitability standards required by law are eligible to invest. This website includes “forward-looking statements” within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. These statements are based upon the current beliefs and expectations of Expanesthetics’ management and are subject to significant risks and uncertainties. There can be no guarantees. These statements are made as of the date of this communication and Expanesthetics assumes no obligation to provide updates.