This document outlines the concept and content of the WHO people-centred approach to addressing antimicrobial resistance (AMR) in the human health sector. The proposed approach recognizes and aims to address the challenges and health system barriers people face when accessing health services to prevent, diagnose and treat (drug-resistant) infections. It puts people and their needs at the centre of the AMR response and guides policy-makers in taking programmatic and comprehensive actions to mitigate AMR in line with a proposed package of core interventions. These interventions are based on a review of four pillars and two foundational steps that are critical to overcome barriers faced by people and health systems in addressing AMR. The four pillars are: (1) prevention of infections; (2) access to essential health services; (3) timely, accurate diagnosis; and (4) appropriate, quality-assured treatment. The pillars are supported by the two foundational steps: effective governance, awareness and education; and strategic information through surveillance and research. Building and adding on to the objectives of the Global action plan on AMR, the 13 core interventions and accompanying priority actions are designed to address AMR in a programmatic manner that puts people, their needs and equitable access to health services at the centre of the AMR response in the community, in primary care, secondary and tertiary care, and at national and/or subnational level. The development of the people-centred core package of AMR interventions was based on a review of the evidence and multidisciplinary expert opinion, complemented with feedback from a global online consultation and WHO’s strategic and technical advisory group on antimicrobial resistance. As countries develop or revise their national action plans (NAPs) on AMR, the people-centred core package of interventions can support the design and prioritization of actions in the human health sector at the different levels of implementation and integrated with broader health system strengthening and pandemic preparedness and response plans.
The purpose of this manual is to provide guidance for countries on the methods and metrics for the surveillance of AMR in selected bacteria causing common human infections. This manual is part of a package of documents and tools designed to inform GLASS implementation and describes the objectives and methodology of GLASS AMR, the GLASS component dealing with the global surveillance of AMR in selected bacteria causing common human infections.
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to improve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants. Definitions of health-care settings are proposed in Appendix 1. These Guidelines and the associated WHO Multimodal Hand Hygiene Improvement Strategy and an Implementation Toolkit (http://www.who.int/gpsc/en/) are designed to offer health-care facilities in Member States a conceptual framework and practical tools for the application of recommendations in practice at the bedside. While ensuring consistency with the Guidelines recommendations, individual adaptation according to local regulations, settings, needs, and resources is desirable. This extensive review includes in one document sufficient technical information to support training materials and help plan implementation strategies. The document comprises six parts.
The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.
When Antibiotics Fail examines the current impacts of AMR on our healthcare system, projects the future impact on Canada’s GDP, and looks at how widespread resistance will influence the day-to-day lives of Canadians. The report examines these issues through a One Health lens, recognizing the interconnected nature of AMR, from healthcare settings to the environment to the agriculture sector. It is the most comprehensive report to date on the economic impact of AMR in Canada.
Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem with an impact on morbidity, mortality and quality of life. At any one time, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI. These infections also present a significant economic burden at the societal level. However, a large percentage are preventable through effective infection prevention and control (IPC) measures. These new guidelines on the core components of IPC programmes at the national and facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC. These are the first international evidence-based guidelines on the core components of IPC programmes. These new WHO guidelines are applicable for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
This practically oriented book provides an up-to-date overview of all significant aspects of the pathogenesis of sepsis and its management, including within the intensive care unit. Readers will find information on the involvement of the coagulation and endocrine systems during sepsis and on the use of biomarkers to diagnose sepsis and allow early intervention. International clinical practice guidelines for the management of sepsis are presented, and individual chapters focus on aspects such as fluid resuscitation, vasopressor therapy, response to multiorgan failure, antimicrobial therapy, and adjunctive immunotherapy. The closing section looks forward to the coming decade, discussing novel trial designs, sepsis in low- and middle-income countries, and emerging management approaches. The book is internatio nal in scope, with contributions from leading experts worldwide. It will be of value to residents and professionals/practitioners in the fields of infectious diseases and internal medicine, as well as to GPs and medical students.
Years of using, misusing, and overusing antibiotics and other antimicrobial drugs has led to the emergence of multidrug-resistant 'superbugs.' The IOM's Forum on Microbial Threats held a public workshop April 6-7 to discuss the nature and sources of drug-resistant pathogens, the implications for global health, and the strategies to lessen the current and future impact of these superbugs.