Recent analysis by the World Health Organization (WHO) underlines the severe impact of healthcare-associated infections (HAIs) on both patients and healthcare workers across the globe. These infections, avoidable with proper infection prevention and control (IPC) measures, have remained a persistent issue hitting hospitals worldwide, and not just during epidemics or pandemics.
Our focus should not just be on acute-care European hospitals where annually, approximately 4.8 million HAIs are recorded. Rather, it is crucial to concentrate on an alarming global statistics wherein 23.6% of the reported sepsis cases are linked to healthcare services. The condition is particularly grave in low- and middle-income nations (LMICs). Poring over the published data, the WHO findings suggest that out of 100 admitted patients in acute-care hospitals in high-income nations, an average of seven acquire one or more HAIs. Conversely, in LMICs, this figure notably doubles to 15%. Notably, the infection rate at intensive care units paints a similar picture. The said rate hovers around 30% overall, but it’s 2 to 20 times higher in LMICs compared to high-income nations.
Adding to the complications, these HAIs are frequently caused by antimicrobial-resistant pathogens, making them challenging to treat. They increase the likelihood of elevated complications, extended hospital stays, and even premature death. The number of antibiotic-resistant HAIs worldwide is projected to be a staggering 136 million annually, with the major share of 119 million blossoming in middle-income nations. The mortality rate among patients infected with resistant HAIs is significantly higher compared to those infected with susceptible pathogens.
To reduce the HAIs burden and mitigate related harm, WHO proposes effective, evidence-based IPC interventions. However, the implementation of these interventions requires significant backing in the form of trained and dedicated healthcare personnel, infrastructure, and financial resources. Despite their proven efficacy and cost-effectiveness in curbing infectious hazard transmissions, these interventions demand support at various levels – institutional, financial, programmatic, and knowledge-based. Yet, WHO’s 2023-24 Tracking AMR Country Self-assessment Survey paints a discouraging picture, as only 39% of nations have nationwide IPC programs fully functional. Worse still, 9% have still not developed any IPC plan.
The implementation of IPC protocols at all healthcare system levels has been slow-paced across all nations, irrespective of income levels. The situation is distinctly complex in LMICs, with their healthcare facility level facing notable roadblocks. Results from WHO’s global surveys in 2019 and 2023-24 show LMICs lagging significantly in IPC core components’ implementation, ranging between ‘inadequate’ and ‘advanced’. The lack of an encouraging environment further cripples the functioning of IPC programs in these nations. Access to clean water remains a significant challenge in these healthcare facilities, with approximately 1.7 billion people in the world in 2022 using healthcare facilities lacking basic water services.
However, recent commitments of WHO member nations have demonstrated a positive shift toward prioritizing IPC measures. At the 75th World Health Assembly, a resolution was adopted marking IPC as a critical priority across the healthcare continuum. Subsequently, a WHO-devised global action plan and monitoring framework for IPC was approved at the 77th World Health Assembly. Targets are set at the global and national levels to increase IPC measures, which demand considerable investments from all countries. The WHO remains supportive of all efforts toward strengthening IPC measures, sharing that added actions and contributions by international donors and non-governmental organizations could make a major difference, particularly in nations with limited resources and expertise.