NIH asked to finalise infection control guidelines

Islamabad: The National Institute of Health (NIH) has been tasked to finalise updated National Guidelines on Infection Prevention and Control (IPC) at the earliest and to bring the provincial health departments on board for effective implementation. The Institute has also been instructed to conduct mapping of available resources for disease surveillance and response in general, and to align ongoing efforts towards building an integrated disease surveillance system.

The PM’s Special Assistant on National Health Services Dr. Zafar Mirza passed on the above instructions to NIH during a meeting held Wednesday as a follow-up to the WHO Field Mission’s debriefing in Karachi. The meeting was attended by Director General Health Dr. Assad Hafeez, Chief of Disease Surveillance Rana Muhammad Safdar, Chief of the Public Health Laboratories Division at NIH Dr. Salman, as well as the WHO Representative Dr. Palitha Mahipala, and WHO’s Regional Adviser on IPC in EMR Dr. Maha Talaat.

The objective of the meeting was to discuss IPC practices across Pakistan vis-a-vis the associated risks and experiences gained from the HIV outbreak in Northern Sindh, where 812 out of the 28,308 people who were screened have tested positive as of June 17.

There was consensus over the need to conduct a quick assessment in a few major hospitals to generate local data and devise a comprehensive plan to avoid infections associated with healthcare settings.

The WHO Mission that investigated the HIV outbreak in Sindh, in coordination with FELTP-NIH and Sindh Health Department, has found the irrational use of injections, reuse of syringes and poor IPC practices in health facilities and clinics as having played a key role in propagation of the infection. As such, the NIH meeting could not have been more appropriately timed. Being a health systems person, Dr. Zafar suggested system-based solutions rather than isolated interventions.

He suggested strengthening of IPC as an integral component of the overall health system so that it applies to public and private sector health facilities across the board. He further stated that the challenges faced by the health system can only be addressed if the federal and provincial governments as well as the international partners work together.

Health care-associated infections (HAI), also referred to as ‘nosocomial’ or ‘hospital’ infections, occur during the process of care in a hospital or healthcare facility; the infection is not present or incubating at the time of admission. HAI represents the most frequent adverse event during care delivery and according to the World Health Organization (WHO), no institution or country can claim to have solved the problem yet. Based on data from a number of countries, it can be estimated that each year, hundreds of millions of patients around the world are affected by HAI.

The burden of HAI is several fold higher in low- and middle-income countries than in high-income ones. There is also now a worldwide consensus that urgent action is needed to prevent and control the spread of antibiotic resistant organisms and in healthcare, effective IPC is one solution.

Every day, HAI results in prolonged hospital stays, long-term disability, increased resistance of microorganisms to antimicrobials, massive additional costs for health systems, high costs for patients and their family, and unnecessary deaths.

Although HAI is the most frequent adverse event in health care, its true global burden remains unknown because of the difficulty in gathering reliable data. IPC is a practical, evidence-based approach, which prevents patients and health workers from being harmed by avoidable infections. Preventing HAIs has never been more important.