World Health Assembly adopts major sepsis resolution

Sepsis, one of the most prevalent but misdiagnosed, deadly diseases has been established as a global priority by the World Health Assembly (WHA), the decision-making body of the World Health Organization (WHO).

The George Institute for Global Health was part of a worldwide alliance which advocated for the adoption of the resolution by the WHA to improve, prevent, diagnose, and manage sepsis through a series of actions around the world.

Professor Simon Finfer, of The George Institute Australia and executive committee member of the Global Sepsis Alliance (GSA) which initiated the push for the resolution, said this was a momentous step in tackling the disease which kills more than six million people globally each year.

Professor Finfer said:

“Around the world sepsis takes the lives of more people than breast or prostate cancer combined, with many of those deaths being entirely preventable.

“It’s essential that we develop a national action plan on sepsis. One that will ensure that people get diagnosed correctly and promptly and for sepsis to be treated as seriously as the other major killers. This resolution is a very welcome move, acting on it will save literally millions of lives.”

Sepsis, also referred to as ‘blood poisoning’, is the life-threatening condition that arises when the body’s response to infection results in organ dysfunction or failure.  Sepsis is often confused with other conditions in its early stages, with delayed recognition of the signs and symptoms quickly leading to multi-system organ failure and ultimately death.

The resolution, which was adopted at the 70^th WHA in Geneva, urges the 194 United Nation Member States to implement appropriate measures to reduce the human and health economic burden of sepsis.

In Australia, The George Institute is working closely with the government and professional organisations to improve sepsis care in Australia. On behalf of the GSA executive Professor Finfer commended the Australian Government for its support and for co-sponsoring the resolution.

Professor Finfer added it was essential that a clinical standard for sepsis was established and that sepsis be documented in the Australian burden of disease statistics to gain a true picture of how many people are affected.

Professor Finfer said: “Sepsis is very poorly understood by the public and can easily be mistaken for the ‘flu. But even when people present at emergency departments or deteriorate in our hospitals, sepsis maybe be misdiagnosed and treatment comes too late.”

The resolution also requests the Director-General of the WHO, to draw attention to the public health impact of sepsis and to 1) publish a report on sepsis and its global consequences by the end of 2018, 2) support the Member States adequately, 3) collaborate with other UN organizations, and 4) report to the 2020 WHA on the implementation of this resolution.

The resolution had the personal support of the outgoing Director-General of the WHO, Dr Margaret Chan. “Community-acquired and health care-acquired sepsis represent a huge global burden that has been estimated to be 31 million cases every year, six million of which result in death,” said Dr Chan. “One in ten patients world-wide acquires one health care associated infection which often manifests itself with sepsis conditions. I commend the member states for the content of the resolution on sepsis which point to key actions that need to be taken to reverse these shocking statistics.”

The WHO has allocated $4.6 million USD to help implement the resolution. The adoption of sepsis as a global priority was initiated by the GSA who gathered the consensus and authority of clinicians and families from over 70 countries. 

“Worldwide, sepsis is one of the most common deadly diseases, and it is one of the few conditions to strike with equal ferocity in resource-poor areas and in the developed world,” said Dr Konrad Reinhart, Chairman of the Global Sepsis Alliance.  “In the developed world, sepsis is dramatically increasing by an annual rate of 5-13 per cent over the last decade.”

The adopted Resolution on Sepsis states:

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

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

3. Sepsis represents the most vital indication for the responsible use of effective antimicrobials for human health. 

4. The UN Member States urgently need 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. Many vaccine-preventable diseases are a major contributor to sepsis in children and adults; national immunization programs are needed urgently. 

6. Sepsis is an emergency that requires time-critical actions, improved training of health care professionals and laypeople. 

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

8. Public awareness needs to be raised and encouraged, for example by using the term ‘sepsis’ when communicating with patients, relatives, and other parties, or by supporting World Sepsis Day, every year on September 13. 

9. Integrated approaches to the prevention and clinical management of sepsis are urgently needed, including access to appropriate health care for survivors. 

10. The International Classification of Diseases (ICD) system needs to be applied and improved to establish the prevalence and profile of sepsis and the development of specific epidemiologic surveillance systems.

Representatives of WHO are set to strike a Task Force with the GSA to develop the strategy to implement the resolution and to secure international political and financial support. 

For its part, the GSA identifies its key priorities as: 1) achieving adequate documentation of sepsis in the global and national disease statistics and reports, 2) encouraging the development of national action plans for all countries, 3) fostering quality improvement initiatives on all levels of care and for all health care settings, and 4) collaborating with governmental and non-governmental bodies focused on strengthening health systems and improving patient safety.