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Resolution on Sepsis by the World Health Assembly Means Quantum Leap in the Fight Against Sepsis

On the unanimous recommendation of the Executive Board of the WHO, the Seventieth World Health Assembly adopted the resolution Improving the Prevention, Diagnosis, and Management of Sepsis” during its annual General Assembly meeting in Geneva (May 22-31, 2017). The resolution represents a major achievement for the Global Sepsis Alliance (GSA) in working to achieve its vision of "A World Free of Sepsis".

Background

In collaboration with the GSA, the resolution was proposed by the German Ministry of Health and supported by Australia, Austria, Colombia, Costa Rica, Estonia, Ireland, Jamaica, Japan, Luxemburg, the Russian Federation, and Switzerland. The resolution highlights poor recognition of sepsis as a major global health issue resulting in millions of preventable deaths each year. With the exception of maternal and neonatal sepsis, sepsis does not feature in the Global Burden of Disease statistics and is thus not afforded priority by policy makers or health care authorities. In addition, it is mostly unknown and poorly understood by the public. Further preventable deaths occur as many healthcare professionals lack training and expertise in the prevention, early recognition, and evidence based management of sepsis as a true time-critical medical emergency.

In most low and middle income countries, an integrated approach to managing sepsis through clinical and laboratory services and timely access to appropriate sepsis care is very limited or absent. In high income countries, effective best practice approaches to the early recognition and management of sepsis are often poorly implemented.

The resolution addresses many goals and targets the GSA and the World Sepsis Day Movement set out in the World Sepsis Declaration in 2012. The resolution urges the 194 UN Member States to implement appropriate measures to reduce the human and health economic burden of sepsis. In the USA, sepsis causes or contributes to half of all deaths in hospitals and has become the leading cause of annual hospitals costs, at 22.4 billion USD per year.

The 10 Key Messages and Requests of the Resolution Are:

  1. That each year sepsis causes approximately six million deaths worldwide, most of which are preventable

  2. That sepsis is a syndromic response to infection and the final common pathway to death from most infectious diseases

  3. That sepsis represents the most vital indication for the responsible use of effective antimicrobials for human health and that in the absence of appropriate and timely clinical management including effective antimicrobials sepsis is almost universally fatal

  4. The urgent call for UN Member States to implement and promote measures for prevention such as: clean childbirth practices, infection prevention practices in surgery, improvements in sanitation, nutrition and delivery of clean water

  5. The reaffirmation that many vaccine-preventable diseases are a major contributor to sepsis in children and adults and that Member States need to integrate cost-effective and affordable new vaccines into national immunization programmes

  6. The affirmation that sepsis is an emergency that requires time critical actions, improved training of health care professionals and lay people

  7. Requires UN Member States to promote research aimed at innovative means of diagnosing and treating sepsis across all ages, including research for new antimicrobial and other novel medicines, rapid diagnostic tests, vaccines and other important technologies, interventions and therapies.

  8. The need to communicate with patients, relatives and other parties using the term “sepsis” to enhance public awareness and the encouragement to engage further in advocacy efforts to raise awareness of sepsis, in particular through supporting existing activities held every year on 13 September (World Sepsis Day) in Member States

  9. The need for integrated approaches to the prevention and clinical management of sepsis including access to appropriate health care for survivors

  10. The request to apply and improve the use of the International Classification of Diseases system to establish the prevalence and profile of sepsis and the development of specific epidemiologic surveillance systems to guide evidence-based strategies for policy decisions

The resolution also requests the Director-General of the WHO to draw attention to the public health impact of sepsis and publish a report on sepsis and its global consequences by the end of 2018, support the Member States adequately, collaborate with other UN organizations, and report to the 2020 WHA on the implementation of this resolution. In support of this resolution, the WHO has allocated about 4.6 million US Dollar to foster its implementation.

Next Steps WHO / GSA Task Force

Key representatives of WHO have already agreed to establish a Task Force with the GSA to develop the most appropriate strategy to prioritize and foster the timely implementation of the key requests of this resolution and to secure the necessary political and financial support on the national and international level for this essential and life-saving work.

The GSA identifies key priorities as: (i) achieving adequate documentation of sepsis in the global and national disease statistics and reports, (ii) encourage the development of national action plans for sepsis, (iii) fostering quality improvement initiatives on all levels of care and for all health care settings (iv) collaborating with governmental and nongovernmental institutions and bodies that are focused on strengthening health systems and improving patient safety.