About International Infection Control

Why it matters

In our increasingly globalized world, infectious diseases can spread at alarming rates, leading to outbreaks in the community and across international borders.

Infection prevention and control

Infection prevention and control (IPC) makes healthcare delivery safer by reducing or eliminating the risk of infection and outbreaks. IPC protects healthcare providers, patients and the surrounding community and is a cornerstone of a strong healthcare system.

IPC in resource-limited healthcare settings can be challenging due to many factors, including lack of trained IPC professionals and healthcare providers, lack of environmental cleaning and healthcare waste management, and limited investment in healthcare infrastructure including facilities, technology and staff.

Healthcare-associated Infections (HAIs)

HAIs are infections that occur in patients while they are receiving health care. HAIs can cause illness and death and are a threat to patient safety.

Most HAIs are preventable. Strong surveillance and IPC programs are essential for preventing HAIs in healthcare facilities.

Antimicrobial resistance (AR)

Antimicrobial resistance (AR) is present in all regions of the world, and new variants are emerging. Antimicrobial-resistant infections can be difficult, and sometimes impossible, to treat.

In 2019, AR is estimated to have and contributed to nearly 5 million deaths, more than either HIV or malaria. That same year, WHO declared AR to be one of the top 10 public health threats facing humanity.

Five of the six most lethal antimicrobial-resistant bacteria are predominantly found in healthcare settings, and antimicrobial-resistant bacteria are being detected in hospitals more often. Tracking AR and carrying out IPC activities are key to prevent the spread of AR in these settings.

Priorities

IICB works with partners on the following priorities:

• Shape IPC policy and programs. Drive global IPC priorities and shape IPC policies and programs at the national and facility level.

• Coordinate action. Coordinate efforts to combat infectious disease threats by developing regional and global networks for AR and HAI surveillance and infection prevention.

• Enhance tracking and reporting. Help laboratories produce the reliable, accurate data needed to detect and track HAIs and AR.

• Advance antimicrobial stewardship. Support antibiotic stewardship programs that can improve how antibiotics are prescribed by healthcare providers and used by patients.

• Promote innovation. Identify effective and low-cost strategies for AR and HAI surveillance and infection prevention through innovative studies and solutions.

• Prepare for and respond to outbreaks. Help countries prepare for and respond to healthcare-related infectious disease outbreaks.

What we've accomplished

Policy, guidance and best practices

• Developed the Africa IPC Legal Framework endorsed by the African Union in 2022, which helps Member States implement and strengthen IPC programs at the national, subnational and healthcare facility level.

• Developed Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings and an implementation toolkit to help healthcare facilities put the best practices into action.

• Supported WHO with developing global guidelines on IPC and AR and the first ever Global IPC Strategy, which provides countries with strategic directions to implement programs for prevention and control of HAIs, including antimicrobial-resistant infections.

• Collaborated with the Association of Southeast Asian Nations (ASEAN) to develop the ASEAN-U.S. IPC Task Force through which governments in Southeast Asia compare experiences and develop materials to enhance IPC and AR activities.

Surveillance and prevention tools and networks

• Launched the Global Action in Healthcare Network (GAIHN) in 2021, a part of CDC's Global Antimicrobial Resistance Laboratory and Response Network, to address emerging infectious disease threats in global healthcare settings.

• Implemented the first nationally representative HAI surveillance networks to monitor trends in healthcare-associated bloodstream and urinary tract infections in India and Vietnam.

• Supported WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) and developed approaches to improve AR surveillance data across its Member States.

• Developed a network of 21 hospitals and 4 regional laboratories focused on improving AR detection and response in Thailand.

IPC programs

• Initiated and established the East Africa IPC Network, including 20 hospitals in Ethiopia, Kenya, Tanzania and Uganda. This network reduces the incidence of healthcare-associated COVID-19 and other HAIs by improving compliance with IPC standards.

• Developed and implemented IPC training programs for IPC specialists in Ethiopia, Nigeria, Sierra Leone and Uganda. These programs strengthen in-country capacity to prevent HAIs and respond to outbreaks.

• Provided IPC and AR technical support to leadership at the Vietnam Ministry of Health and training and mentorship to over 50 member hospitals of their IPC and AR surveillance networks.

Laboratory and surveillance programs

• Developed and launched the Laboratory Assessment of Antibiotic Resistance Testing Capacity (LAARC), which is used in hundreds of laboratories across dozens of low- and middle-income countries to identify and correct laboratory practices that can contribute to inaccurate AR data.

• Helped participating GAIHN facilities with limited resources in Brazil, Indonesia and the Philippines better estimate HAI prevalence, identify HAI/AR pathogens and determine major infection sites.

• Worked with laboratories in 15 hospital in Brazil to enhance their ability to detect antimicrobial-resistant pathogens and increase the number of clinical laboratories reporting to the national AR surveillance program, which shares critical AR data with WHO GLASS.

Antimicrobial stewardship

• Developed Core Elements of Human Antibiotic Stewardship in Resource-limited Settings to guide the development of policies and programs that promote the appropriate use of antibiotics.
• Developed the Global Antibiotic Stewardship Evaluation Tool to help inpatient healthcare facilities and antibiotic stewardship programs identify areas of improvement and track progress over time.
• Evaluated the impact of the COVID-19 pandemic on trends in inpatient antibiotic use in six hospitals in Southeast Asia (Indonesia and Philippines) and 6 hospitals in South America (Brazil, Argentina, and Chile).

Innovative studies and activities

• Evaluated bloodstream infections (BSIs) in 4,073 newborns in India, leading to the implementation of prevention measures and initiation of a study to investigate causes of newborn BSIs.

• Evaluated a target assessment tool for BSI prevention in 7 neonatal intensive care units (NICUs) in Brazil, Colombia and Paraguay. Now, more than 200 healthcare providers in these NICUs use the tool to address gaps in IPC.

• Completed a study with GAIHN partners in Argentina showing that hospitals can use locally-available rectal swabs for a laboratory method that speeds carbapenemase detection in hospitals, making the method a feasible option for hospitals in the country.

• Used data from Antibiotic Resistance in Communities and Hospitals (ARCH) studies to identify and respond to the source of an outbreak of an antimicrobial-resistant bacteria in a neonatal intensive care unit in Botswana.

Outbreak preparation and response

• Since 2014, have responded to more than 21 outbreaks in more than X countries

• Supported delivery of COVID-19 IPC virtual trainings to over 16,100 healthcare workers in more than 1,520 healthcare facilities in 5 countries.
• Supported training for more than 700 healthcare providers in Uganda on navigating the 2022 Ebola outbreak and developed an Ebola IPC supervisor training program to help facilities sustainably implement IPC strategies and measures.

Where we work

The work of IICB would not be possible without our partners. Since 2014, IICB has worked with partners in the U.S. and more than 44 countries to advance global healthcare safety, including:

• Ministries of health
• Global public health organizations
• Academic institutions
• Other governmental organizations
• Non-governmental organizations