WHA70.7 Resolution - Progress and achievements

Improving the prevention, diagnosis and clinical management of sepsis

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• In September 2020 WHO published the Global report on the epidemiology and burden of sepsis: Current evidence, identifying gaps and future directions. 
• Led the development of a consensus definition of maternal sepsis and conducted two large multi-country facility-based studies on maternal infections and abortion-related complications. 
• Launched the SAVE LIVES: Clean Your Hands campaign: It’s in your hands – prevent sepsis in health care, calling on health facilities to prevent health care-associated sepsis through hand hygiene and infection prevention and control (IPC) action, which included a  campaign advocacy toolkit and involved 20 935 health facilities in 180 countries. 
• Implemented a campaign on health care workers’ awareness and appropriate management of maternal sepsis in 46 countries.
• Took part in a multi-institutional collaboration to estimate the global burden of GBS invasive disease.  estimate the global burden of GBS invasive disease 
• Promotes updated and internationally standardised classification and coding of sepsis states, and the specification of related details such as AMR patterns and in the International Classification of Diseases 

The third pillar of the resolution is to support Member States to define standards and establish guidelines, infrastructure, laboratory capacity, strategies, and tools for reducing incidence of, and morbidity and mortality due to sepsis. As such, WHO:

• Developed the first  Global strategy on infection prevention and control
• Released a self-pace training package on infection prevention and control in maternal and neonatal care.
• Supported countries in building clinical microbiology and epidemiology capacities and generated surveillance data on antimicrobial resistance (AMR) in bacteria including sepsis pathogens with the Global Antimicrobial Resistance Surveillance System (GLASS)  
• Adopted WHA resolution on WASH in health care to improve water, sanitation and hygiene (WASH) as a critical element of infection prevention. 
• Developed WASH implementation resources (e.g. practice guidelines, video) and worked with UNICEF and partners to support global implementation.
• Facilitated research to evaluate the efficacy of simplified antibiotic regimens for the management of young infants with signs of PSBI when referral is not feasible. Also facilitated implementation research and scaling-up of new PSBI guidelines in numerous African and Asian countries. 
• Launched with UNICEF a global report Survive and Thrive Transforming Care for Every Small and Sick Newborn, which highlights the burden of neonatal sepsis, and health system solutions to address it. 
• Developed and piloted the Integrated Interagency Triage Tool for early identification and management of sepsis  
• Published the ICD-11 with completely updated classification of sepsis and related states, facilitating the reporting of sepsis as a risk factor for death and long-term sequelae. Evolving and emerging medical and scientific understanding of sepsis is able to be included in the ICD-11 via the proposal platform. WHO is also supporting Member States to implement ICD-11, which allows identification and standardized reporting of sepsis via ICD-11. 
• Published a landscape of in vitro diagnostics (IVDs) and the model list of essential IVDs, including IVDs that play a role in the diagnosis of sepsis.
• Launched a new WHO/UNICEF Water and Sanitation for Health Facility Improvement tool (WASH FIT V 2.0) and training guide with greater focus on safely managed water and sanitation supplies to prevent infections (including sepsis) and a focus on equity, in particular birthing settings were maternal and neonatal sepsis is still high. 
• Released the  WHO/UNICEF Joint Monitoring Programme global report and updated global database on water, sanitation, hand hygiene, health care waste and cleaning in health care facilities, covering 153 countries, representing nearly 1,000,000 health care facilities. Basic infrastructure necessary for IPC and preventing and treating sepsis are still very low, with 50% of health are facilities globally lacking hand hygiene at points of care.

The fourth pillar of the resolution is to collaborate with UN organizations, partners, international organizations and stakeholders to enhance sepsis treatment and infection prevention and control including vaccinations. In this role, WHO is:

• Collaborating with the Surviving Sepsis Campaign to create comprehensive, inclusive clinical guidelines for sepsis 
• Developing, in collaboration with  Neonatal AntiMicrobial Resistance (NeoAMR), new, globally applicable, empiric antibiotic regimens and strategies for neonatal sepsis. 
• Developing a value proposition for the Group B Streptococcus vaccine with international and national experts. 
• Launched Standards for improving quality of maternal and newborn care in health facilities and the Standards of care for small and sick newborns, which include hospital assessment and management of sepsis and ways to improve quality of maternal and neonatal services.