Equitable ECO initiatives, particularly in humanitarian crises, witness to health systems characterized by continuity of care rather than fragmentation and abandonment. ECO functions best when it incorporates community-based health workers and volunteers who know their own settings, customs, and cultural preferences. ECO perioperative care begins with and is accountable to communities, spanning the continuum from prevention to palliative care.

ECO tackles high-burden disease in low-resource settings—trauma, sepsis, obstetric complications, NCD emergencies, and respiratory illnesses. Including local and national professional organizations, CSOs, faith-based organizations and indigenous communities, can ensure that marginalized populations are not sidelined. These populations include
Older persons with chronic diseases, including cancer, heart disease, organ failure, and dementia
Persons with mental and physical disabilities, surgical disease, and traumatic injuries
Newborns and children with severe health complications
Persons deprived of liberty
Refugees and migrants

Without appropriate treatment and palliative care, these individuals may endure severe pain, untreated symptoms, psychological distress, and undignified deaths.

We recommend
Aligning ECO with existing national policies and strategies
contextualizing rather than just standardizing systems of caring
focusing on quality holistic health and care services across the life course that include patients and their families
training for improved communication, teamwork, and technical skills, as well as care that is person-centred and culturally and spiritually relevant.
Embedding anesthesiologists, pain specialists, and palliative care practitioners in national ECO planning and governance.