Lifebox 2020 Impact Report

Throughout the COVID-19 pandemic, surgical teams around the world have continued to provide essential care to their patients. Lifebox’s work to ensure the safety of our partners and their patients has been more crucial than ever. We focused on supporting our global network by developing tools and resources for safe surgical, anesthesia, and COVID-19 care.

It has been a difficult year, but we have achieved significant milestones worth celebrating. We launched the Smile Train- Lifebox Safe Surgery and Anesthesia Initiative to strengthen surgical systems globally, and published the positive results of the Lifebox Clean Cut program in the British Journal of Surgery.

As you read this Impact Report, we hope that you are proud of the work we achieved together this year. Thank you for your continued support.


All of us will have a moment in our lives when either we, or a loved-one, need surgery. Whether it’s due to an accident, illness or giving birth - many of us will take this access to safe surgery as a given.

This is not true for the five billion people that lack access to safe, affordable, and effective surgery. Surgical teams around the world face significant challenges in providing the best possible quality care to their patients. Lifebox is a global nonprofit working to improve the safety of surgery and anesthesia in low- and middle-income countries. Co-founded and chaired by Dr. Atul Gawande, Lifebox works to improve anesthesia safety, reduce surgical infection rates, and strengthen surgical teamwork through tools, training, and partnerships.

Since 2011, Lifebox has:


The need for surgery has not stopped during the COVID-19 pandemic. Surgical teams around the world have continued to provide lifesaving surgery, even when lacking basic equipment to keep themselves safe. From distributing 6,500 pulse oximeters for the management of COVID-19 patients, to reducing the risk of infection to surgical teams, and fostering innovations to tackle COVID-19, Lifebox is supporting our partners in providing safe surgical, anesthesia, and COVID-19 care.

"Lifebox responded rapidly to COVID-19. In the absence of good testing, being able to have a pulse oximeter on the finger of a person with a cough and detect those with low oxygen levels has proven to be incredibly important across the world, especially in places like Sub-Saharan Africa and Latin America where Lifebox operates. With 6,500 pulse oximeters distributed thus far, work continues apace - with Lifebox doing incredible things at scale."

Dr. Atul Gawande, Lifebox Chair

Thank you to Lifebox supporters, The ELMA Relief Foundation, IZUMI Foundation, Smile Train, Stavros Niarchos Foundation, and UBS Optimus Foundation for supporting our COVID-19 response.


We’ve joined forces with Smile Train to launch the Smile Train-Lifebox Safe Surgery and Anesthesia Initiative - a multi-year strategic partnership to elevate the quality and safety of cleft and pediatric surgery in more than 70 countries. Through capacity building, innovations, and research, the Initiative will strengthen the surgical systems of over 1,000 hospitals around the world.


Published in the British Journal of Surgery in September 2020, the results of Clean Cut, Lifebox’s surgical site infection (SSI) reduction program, showed a 35% reduction in the risk of SSIs by improving adherence to six essential perioperative infection prevention practices with no major investments in new infrastructure or resources.

Lifebox is scaling Clean Cut at sites in Ethiopia, India, Liberia, and Madagascar, as well as adapting its use to improve the safety of C-sections as part of the Bill & Melinda Gates Foundation’s Grand Challenges Initiative, funded by UBS Optimus Foundation.


Lifebox is part of a broad coalition of individuals and organizations from the global surgery community working to identify and address issues of neocolonialism and inequities in global surgery. In November 2020, Lifebox co-hosted an online event chaired by Professor Emmanuel Ameh on “Transformational Dialogues Towards Decolonizing Global Surgery”. The coalition plans for a series of events in 2021 focusing on topics including access to opportunities in research, training, and funding.


Lifebox’s core strength lies in its partnerships. Our global network spans surgical teams, professional societies, ministries of health, and other nonprofits to strengthen surgical systems around the world.


Global Governance Council

Lifebox is steered by a Global Governance Council with its roots in the WHO Surgical Safety Checklist. The Council brings decades of experience spanning clinical work, research, community engagement, and resource management to govern Lifebox’s global team and safer surgery vision.


Lifebox 2019/2020 Annual Financial Information

Consolidated Lifebox annual accounts from audited Lifebox Foundation USA and audited Lifebox Foundation UK for the period 1 April 2019 to 31 March 2020.


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