Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in IndiaBMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3768 (Published 05 September 2017) Cite this as: BMJ 2017;358:j3768
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Re: Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in India
As we enter the week of mobilization against antibiotic resistance, this emphasis on Infection Prevention and Control (IPC) is most timely, long overdue. For the past two years we, at AMR Times, have been conducting a watch on AMR news, and today 80% or even more is on PPP to improve the antibiotics pipeline or on decreasing use by individual patients and docs. Fine and well. But...
What's wrong with that? If AMR kills, - shortens the life span - of an estimated 700 000 patients a year (and it will go to 10 million a year, according to AMR Review of Jim O'Neill), it is because we are neglecting the issue of CONTAINMENT.
AMR will always affect some patients, but if your healthcare systems are dirty, drug-resistant infection will be spread to healthcarers and to other patients. Ebola was extreme, but it killed most because of lack of protective equiment in health care systems!
Attending the UN General Assembly in NYC on AMR in Sept 2016, I heard only 6 countries out of over 120, mention IPC, same very low % in the WHO Executive Board meetings and the World Health Assemblies ever since AMR is being discussed: countries are NEGLECTING infection control, most facilities in LMIC are terribly filthy, even on the European continent, over 20 countries don't have IPC systems in place. We need training, publications such as this one, we need committments to clean care which is part of the Right to Health. There is no way one can control and contain AMR infections in one's own backyard. We are all together in this. WE NEED IMMEDIATE MASSIVE CAMPAIGNS AND INVESTMENTS IN IPC NOW! As the World Summit on TB approaches, I'm concerned resolutions do not even mention the risks of contamination with MDR TB in overcrowded waiting rooms of doctors offices, in hospitals or in prisons. Yet, even the newest drugs won't stop the TB epidemic if we can't contain and decrease transmission at the same time. Dr Soumya Swaminathan spoke of the poverty drivers in TB recently. There is also 'poverty' in health systems which means filth. We won't beat AMR with new drugs alone, we need CONTAINMENT, and IPC will need also a massive effort for DIAGNOSTICS, including building up capacities in LICS and changing regulations so they are regularly proposed, used and reimbursed in health systems.
You can look up our comprehensive and prestigious overview in AMR Control (www.amrcontrol.info), or get in touch with us at firstname.lastname@example.org, or email@example.com. We rejoiced at the publication of the Indian national guidelines on IPC. We need an international strike force to bring about clean care everywhere (including water and sanitation, as Jim O'Neill had it in Chapter 6 of the AMR Review).
Competing interests: No competing interests