Recommendations from the APEC High-Level Workshop on Reducing the Economic Burden Of

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2012/CSOM/017

Agenda Item: 2a

Recommendations from the APEC High Level Workshop on Reducing the Economic Burden of Healthcare-Associated Infections

Purpose: Consideration

Submitted by: CTI/LSIF

RECOMMENDATIONS FROM THE APEC HIGH LEVEL WORKSHOP ON REDUCING THE ECONOMIC BURDEN OF HEALTHCARE-ASSOCIATED INFECTIONS

EXECUTIVE SUMMARY

The LSIF in collaboration with the Health Working Group organized the APEC High-Level Workshop on Reducing the Economic Burden of Healthcare-Associated Infections (HAIs) in Manila, Philippines on 25-26 July, 2012. Over 150 representatives from 18 APEC Member Economies, the World Health Organization, the Asian Development Bank, the International Nosocomial Infection Control Consortium (INICC), and the Asia Pacific Society of Infection Control (APSIC) participated in the meeting. Participants discussed the public health and economic burden of HAIs in the region, which is estimated to afflict 5-19 percent of hospitalized patients and are a significant drain on health systems and government budgets. Participants also shared examples of effective policies and programs for addressing HAIs at both the economy and healthcare institution levels, and identified ways in which governments, patients, the private sector, and academia could work together to improve HAI prevention and control within economies.

The meeting agreed on a set of three initial steps APEC Member Economies should undertake to begin reducing the huge economic burden of HAIs in their economies: (1) invest in infection prevention and control policies and programs; (2) enhance data collection and surveillance; and (3) encourage partnerships and collaborations to help tackle the HAI burden. The meeting concluded with a set of recommendations (attached) calling on Ministers to recognize the economic and public health burden of HAIs and encouraging APEC Member Economies to commit to working with stakeholders to reduce the incidence of infections in healthcare settings by establishing surveillance systems, baseline measurements, and targeted reduction goals at the economy and local levels by 2015.

Recommendations

• Welcome the target of reducing the incidence of infections in healthcare settings by establishing surveillance systems, baseline measurements and targeted reduction goals at the economy and local levels by 2015.
• Request an annual progress report.

Recommendations from the APEC High-Level Workshop on Reducing the Economic Burden of Healthcare-Associated Infections

25 – 26 July 2012

Manila, Philippines

Overview

Over 150 representatives from government, industry, and academia from Australia, Brunei Darussalam, People's Republic of China, Hong Kong, China, Indonesia, Japan, Republic of Korea, Malaysia, Mexico, Papua New Guinea, Peru, the Philippines, Russia, Singapore, Chinese Taipei, Thailand, the United States, and Viet Nam convened in Manila, the Philippines on 25-26 July, 2012 for the APEC High-Level Workshop on Reducing the Economic Burden of Healthcare-Associated Infections (HAIs). Senior representatives from several international and regional organizations, including the World Health Organization (WHO), the Asian Development Bank (ADB), the International Nosocomial Infection Control Consortium (INICC), and the Asia Pacific Society of Infection Control (APSIC), also participated in the meeting.

Throughout the two-day workshop APEC economies discussed the public health and economic burden of HAIs throughout the region, shared examples of effective policies and programs for addressing HAIs at both the economy and healthcare institution levels, and identified ways in which governments, patients, the private sector, and academia could work together to improve HAI prevention and control within economies. Participants developed a set of recommendations on how APEC Member Economies could work both individually, at the government and healthcare institution levels, and collaboratively through the APEC forum to reduce the economic and health burden of HAIs on healthcare systems.

Background

An HAI is an infection occurring in a patient during the process of care in a healthcare facility which was not present or incubating at the time of admission. HAIs are sometimes referred to as nosocomial infections, or hospital infections. Exposure can be caused by transmission from contaminated healthcare workers’ hands, environmental surfaces, patient-to-patient contact, as well as catheter insertion and maintenance practices.

The WHO has identified HAIs as a leading cause of preventable morbidity and mortality, and an area where investment in preventive measures would yield significant cost savings and public health benefits. According to the WHO, HAIs affect hundreds of millions of patients worldwide each year and estimates the prevalence in hospitals to be 5-12% in developed economies and 5-19% in developing economies. The WHO estimates that in some developing economies, more than 25% of patients admitted to hospitals acquire HAIs. As a result, the total number of patients impacted worldwide each year is in the hundreds of millions.

Recommendations

We call on APEC Member Economies to recognize the tremendous health and economic burden healthcare-associated infections (HAIs) place on economies, health systems, patients and their families, and healthcare workers and to recognize that HAIs threaten to undermine the gains achieved and investments made in our health systems to date.

We encourage APEC Member Economies to:

1. Invest in Infection Prevention and Control Policies and Programs

Economy Level

• Develop, execute, and maintain policies and programs with adequate resources, including trained personnel and infrastructure that are needed to establish and maintain their effectiveness.

• Establish both short- and long-term goals for HAI management and reduction, as appropriate according to the level of resources, to encourage improved outcomes and identify effective solutions and interventions.

Local and Institutional Level

• Ensure the establishment of policies and programs at the local levels, and ensure their implementation in healthcare settings through effective strategies, including program support and oversight.

• Establish both short- and long-term goals for HAI management and reduction, as appropriate according to the level of resources, to encourage improved outcomes and identify effective solutions and interventions.

1. Enhance Data Collection and Surveillance

Economy Level

• Establish surveillance systems for HAIs, antimicrobial resistance, and other outbreaks of organisms of concern.

Local and Institutional Level

• Ensure the establishment of HAI and AMR surveillance systems and advance the use of surveillance data for performance improvement.

1. Encourage Partnerships and Collaborations

All Levels

• Work collaboratively through international organizations, professional societies, and patient and healthcare worker organizations to enhance awareness and implementation of policies and best practices to reduce the health and economic impact of HAIs.

• Encourage multi-sector collaboration and public-private partnerships to increase awareness, improve capacity and share best practices.

• Leverage knowledge and resources from multiple sectors to achieve goals that may not otherwise be attainable by working independently.

Call to Action

We call on APEC Ministers to recognize the economic and public health burden of healthcare-associated infections, which are estimated to afflict 5-19 percent of hospitalized patients and are a significant drain on health systems and budgets. We encourage APEC Member Economies to commit to working with stakeholders to reduce the incidence of infections in healthcare settings by establishing surveillance systems, baseline measurements, and targeted reduction goals at the economy and local levels by 2015.

References:

1. Report on the endemic burden of healthcare-associated infection worldwide. World Health Organization, Geneva, Switzerland, 2011. Available at
2. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D. Burden of endemic healthcare-associated infection in developing economies: a systematic review and meta-analysis. The Lancet 2011; 377:228-41.
3. Health care-associated infections FACT SHEET. World Health Organization, Geneva, Switzerland, 2011. Available at
4. WHO. Core components for infection prevention and control programmes. Report of the Second Meeting Informal Network on Infection Prevention and Control in Health Care. June 26–27, 2008. (accessed July 23, 2010).
5. WHO. Aide-memoire on the core components. Available at
6. WHO Regional Committee for the Eastern Mediterranean, Technical Paper: Infection prevention and control in health care: time for collaborative action. August 2010.