Why Every Health System Needs to Put EECC First
Walk into any hospital today and you’ll see a familiar structure. Wards are divided by specialty: surgery, medicine, paediatrics, obstetrics, and more. Patients are usually slotted into one of these categories based on their condition. While this system works well for organising care by disease type, it often misses one of the most urgent and important needs in the hospital: critical illness.
Critical Illness Is Everywhere—Not Just in the ICU
Critical illness is the most severe form of any acute condition. It means a person has vital organ dysfunction, is at high risk of dying without urgent action, but can potentially recover if treated quickly. These patients aren’t only found in intensive care units (ICUs)—in fact, studies like ACIOS and HBCIGS show that up to 94% of critically ill patients are found in general wards.
Right now, essential care for these patients—what we call Essential Emergency and Critical Care (EECC)—is not prioritised. It’s not because it’s expensive or complex. Quite the opposite. EECC includes simple but life-saving actions like monitoring vital signs, giving oxygen, providing IV fluids, managing the airway, and training health workers to act fast. These steps are low-cost, easy to deliver, and can be done in any hospital setting.
This is how most health systems are organised
EECC Is the Foundation—Advanced Care Comes Later
Health systems often focus first on specialised treatments and high-tech care. Advanced critical care, found in ICUs, is important—but it’s only part of the picture. Every critically ill patient, whether they’re in the emergency unit, an operating theatre, or a general ward, needs EECC. Without it, even the best ICU care may arrive too late.
EECC should be the foundation of a functioning health system. It’s the first tier of response for any critical illness, no matter the cause or the ward. It’s also highly adaptable—tasks can be shared between different health workers, making it suitable even in low-resource settings. Only a sub-group of critically ill patients need advanced critical care. But all need EECC.
And this is how health systems should be organised
It’s Time to Make EECC Everyone’s Priority
So why isn’t EECC prioritised? One reason is that health systems are still designed around diagnosing and treating specific diseases. But critical illness doesn’t wait for a diagnosis—it needs immediate, cross-cutting care. Another reason is that EECC is “everyone’s job,” and when something belongs to everyone, it can sometimes end up being no one’s responsibility.
It’s time for that to change. EECC doesn’t replace specialities—it supports them. It ensures that the most urgent needs are met, no matter where a patient is in the hospital or what their diagnosis is. By putting EECC at the core of health systems, we can make care safer, fairer, and more effective—and save many more lives.