Search the hub

“When the medicine no longer works, the patient suffers twice: first from the illness, then from the cost, fear, and uncertainty that follows.” Across Uganda, patients are increasingly experiencing infections that no longer respond to commonly used antibiotics. Conditions that were once easily treatable now require longer hospital stays, repeated courses of treatment and higher out-of-pocket expenditure. These lived experiences reflect the human impact of antimicrobial resistance (AMR), a growing threat to patient safety, equity and health system resilience.[1] Although antimicrobial stewardship (AMS) has traditionally focused on prescribers, laboratories and health facilities, evidence from Uganda demonstrates a critical reality: a large proportion of antibiotic use occurs at community and household level.[2] Without engaging patients and communities as partners, stewardship efforts remain incomplete and unsustainable. Annet Naguudi, Regina Kamoga and Joshua Wamboga from the Uganda Alliance of Patients’ Organizations (UAPO) argue that strengthening AMS in Uganda requires placing patients at the centre of the response and highlights the strategic positioning of the UAPO to lead this shift in line with national and global priorities. The AMR challenge in Uganda: More than a technical problem Uganda is experiencing increasing resistance to widely used antibiotics, including amoxicillin, ciprofloxacin, ceftriaxone, gentamicin and cotrimoxazole.[2][3] Surveillance and hospital-based studies show a rising prevalence of multidrug-resistant organisms, particularly extended-spectrum β-lactamase (ESBL)–producing Enterobacterales and methicillin-resistant Staphylococcus aureus (MRSA).[2] Drug resistance has also been documented across priority disease programmes. Uganda’s first national tuberculosis (TB) drug-resistance survey reported resistance to any first-line anti-TB drug in 10.3% of new patients and 25.9% of previously treated patients, with multidrug-resistant TB reaching 12.1% among the latter group.[4] In malaria, resistance to chloroquine and later sulfadoxine-pyrimethamine emerged in the 1990s and early 2000s, prompting successive changes in national treatment policy toward artemisinin-based combination therapies.[5] HIV drug resistance has similarly increased over time, particularly to non-nucleoside reverse transcriptase inhibitors, contributing to Uganda’s transition to dolutegravir-based first-line regimens with a higher barrier to resistance.[6][7] Together, these trends highlight AMR as a cross-cutting threat requiring coordinated AMS across human health programmes. For patients, AMR translates into: Delayed recovery and treatment failure. Prolonged hospital admissions. Increased healthcare and household costs. Reduced trust in health services. These outcomes are not driven by clinical factors alone. Patient behaviour and community norms, including self-medication, incomplete adherence to treatment, pressure on clinicians to prescribe antibiotics and sharing of medicines within households, are major contributors to inappropriate antimicrobial use in Uganda.[1][8] Addressing this is therefore essential to effective AMS. Strong policy commitment, persistent implementation gaps Uganda has demonstrated strong political commitment to addressing AMR through the National Action Plan on Antimicrobial Resistance II (NAP-AMR II) 2024/25– 2028/29, which aligns with the WHO Global Action Plan on AMR and adopts a One Health approach spanning human, animal and environmental health.[1][8] Key achievements include: Establishment of a national AMR Secretariat. Adoption of the WHO Access, Watch, and Reserve (AWaRe) antibiotic classification. Piloting of AMS committees in selected regional referral hospitals. Annual national AMR awareness campaigns. However, despite these advances, AMS implementation remains uneven. Stewardship activities are largely concentrated in tertiary facilities, diagnostic capacity is limited in many settings, and surveillance systems do not adequately capture community-level antimicrobial use.[8] Critically, patient engagement is not yet systematically embedded within AMS implementation, limiting the reach and sustainability of national efforts. Why patient engagement is central to AMS AMS is most effective when patients are not passive recipients of instructions but active partners in care. Patients influence antimicrobial use at every stage: care-seeking behaviour, expectations during clinical encounters, adherence to prescribed treatment and medicine use within households.[1] Meaningful patient-centred AMS ensures that patients are: Informed, with clear and accessible information about when antibiotics are needed. Empowered, able to ask questions and participate in shared decision-making. Engaged, involved in shaping stewardship messages and interventions. Partners in accountability, reinforcing appropriate use within families and communities. Evidence increasingly shows that stewardship interventions incorporating patient education and community engagement achieve more durable behaviour change than provider-only approaches.[9] The strategic role of patient organisations Patient organisations occupy a unique position within health systems. Rooted in lived experience and trusted by communities, they can translate complex technical guidance into culturally relevant messages, strengthen trust and support accountability for quality and safety. UAPO is a national umbrella body representing 18 patient organisations across diverse disease areas. UAPO provides a unified, patient-centred platform that aligns closely with Uganda’s AMR priorities, particularly in: Rational medicine use. Community awareness and behaviour change. Patient safety and quality of care. Accountability and transparency in health systems. UAPO does not replace government leadership or clinical stewardship. Rather, it complements national and facility-based AMS efforts by anchoring stewardship in lived experience and community practice, consistent with WHO guidance on meaningful patient engagement.[10] Demonstrated patient-led innovation: The CHAIN experience A compelling example of patient-centred AMS in practice is provided by Community Health and Information Network (CHAIN), a UAPO member organisation. CHAIN has developed an innovative gamification-based approach to antimicrobial stewardship education that targets children as agents of change. Through interactive play, storytelling and peer learning, children are taught: When antibiotics are needed—and when they are not. The importance of correct dosing and completing treatment. Hand hygiene and infection prevention. The risks of sharing or misusing medicines. To date, this approach has reached over 20,000 children in rural and urban communities and has demonstrated measurable improvements in hygiene and medicine safety behaviours (UAPO internal programme data). Children trained through the programme act as AMR champions, influencing parents and caregivers and reinforcing responsible antimicrobial use at household and community levels. This early-life intervention addresses AMR at its behavioural roots and complements facility-based stewardship and regulatory interventions.[8] UAPO’s positioning to lead a national patient-centred AMS campaign UAPO is uniquely positioned to lead a national campaign on strengthening AMS through patient engagement by offering: National convening power to bring together patients, clinicians, policymakers, regulators, and partners. Trusted community reach through established patient networks. Strong alignment with national policy, particularly NAP-AMR II. Scalable community-based models that complement technical AMS interventions. A sustainability focus, embedding stewardship behaviours early and across generations. Through this role, UAPO can help ensure that AMS is not only implemented, but understood, owned and sustained by the communities it serves, reinforcing national AMR objectives.[8] Conclusion: From policy to people Uganda has laid strong foundations for addressing antimicrobial resistance through robust policies and multi-sectoral coordination. However, the next phase of progress depends on translating policy and technical guidance into everyday decisions made by patients and families. Strengthening antimicrobial stewardship without engaging patients risks short-lived gains. By placing patients at the centre of AMS and by supporting patient organisations, such as UAPO as partners and conveners, Uganda has an opportunity to demonstrate how meaningful patient engagement can accelerate stewardship, protect life-saving medicines and strengthen health system resilience. Investing in patient-centred AMS is not optional; it is essential. References World Health Organization. Global action plan on antimicrobial resistance, 2015. Okiror JJ, Aruhomukama D, Kajumbula H. Kateete DP. Trends in antimicrobial resistance from sentinel surveillance sites in Uganda. BMC Infectious Diseases 2024; 24: Article 912. Ndugga P, Mboowa G, Karamagi C, Taremwa IM. Antimicrobial resistance patterns among priority bacterial pathogens in Uganda. BMC Infectious Diseases 2024; 24: Article 930. https://doi.org/10.1186/s12879-024- 09806-y. Lukoye D, Adatu F, Musisi K, et al. Anti-tuberculosis drug resistance among new and previously treated sputum smear-positive tuberculosis patients in Uganda: Results of the first national survey. PLoS ONE, 2023; 8(8): e70763. https://doi.org/10.1371/journal.pone.0070763. Kamya MR, Bakyaita NN, Talisuna AO, et al. Increasing antimalarial drug resistance in Uganda and revision of treatment guidelines. The Lancet 2002; 360(9341): 451–2. https://doi.org/10.1016/S0140-6736(02)09609-7. WHO. HIV drug resistance report 2019. World Health Organization, 2019. Wittkop L, Günthard HF, de Wolf F, et al, WHO HIVResNet. Effect of transmitted drug resistance on virological and immunological response to initial combination antiretroviral therapy for HIV. The Lancet HIV 2021; 8(3): e167–e77. https://doi.org/10.1016/S2352-3018(20)30338-7. Ministry of Health (MoH), Republic of Uganda. National Action Plan on Antimicrobial Resistance II (2024/25–2028/29). Government of Uganda, 2025. WHO. Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries: A WHO practical toolkit. World Health Organization, 2019. WHO. Framework on integrated, people-centred health services. World Health Organization, 2016. Further reading on the hub: Why won’t my doctor give me antibiotics? Ron Daniels explains My involvement with the Commonwealth Partnerships for Antimicrobial Stewardship Scheme (CwPAMS) in Zambia Top picks: Key resources on antimicrobial resistance Do you have insights to share around patient safety? We would love to hear from other countries and organisations on the work they are doing. Are you a member of the hub? Why not join our global community today (it’s free and easy to sign up) and submit an article or share a resource? You can also contact the editorial team at [email protected].

Philly Baines is a patient advocate and Founder of Thrush Support. She is living with chronic pain following recurrent thrush infections and vulval nerve damage.  In this opinion piece, Philly shares her experience and calls for action to make sure patients and healthcare professionals are more aware of the risk of thrush-associated nerve damage. She highlights the devastating impact chronic vulval pain has on people’s lives and why prevention is key.  Experience of thrush in my 20s From the age of 22, I experienced one episode of thrush almost every year. Thrush is not taught in schools or universities, so when I had my first infection, I relied on my mother’s knowledge and over-the-counter treatment. This lack of education is striking given that around 75% of women will develop thrush at some point in their lives.[1] Throughout my 20s, my thrush infections were short-lived and typically resolved within a week. I never met the medical definition of “recurrent thrush”, which is four or more infections in a year,[2] and therefore was never eligible for specialist referral . By the age of 32, my go-to treatment - clotrimazole pessaries - stopped working. This was due to candida albicans (the fungus associated with thrush) developing resistance from repeated over-the-counter use. NHS guidance[3] advised that it was safe to drink alcohol while taking antifungals, so I did. Now I know that alcohol floods the body with sugar, feeds yeast, and lowers innate immunity, increasing the likelihood of treatment failure.[4] This resulted in a severe thrush infection that lasted two months. During this time, inflammation caused nerve damage and pain in my vulval vestibule (where the vulva meets with the vagina). Harmful lack of knowledge In October 2022, after two months of treatment, I tested negative for thrush, but the burning pain in my vulval vestibule persisted. The NHS thrush clinic treating me had no clinicians trained in vulval pain, so my ongoing symptoms were not recognised as vulvodynia (vulval pain) or vestibulodynia (pain at the vulval vestibule). I was never diagnosed with nerve damage. Over the following six months, the pain gradually subsided but in October 2023, I developed thrush again. This time, the pain never went away A gynaecologist misdiagnosed me with a controversial condition, 'cytolytic vaginosis' (overgrowth of good bacteria) and I was prescribed an antibiotic called co-amoxiclav.I was prescribed an antibiotic called co-amoxiclav to ‘knock down the good bacteria’ in my vagina. This triggered recurrent drug-resistant thrush and worsened the existing nerve damage. My pain went from 2/10 to 7/10. The gynaecologist had no vulval training and unfortunately the treatment I was given has caused me to become disabled by pain. Key areas for change: information and training NHS information: The NHS thrush webpage should include the information from the Vulval Pain Society[5] and British Association of Dermatologists[6] and warn women of the link between thrush and vulval nerve damage. This way women can be supported to take recurrent or severe thrush seriously. I am calling for their webpage to include the following two sentences: “There is an association between thrush and vulval nerve damage, a chronic pain condition called vulvodynia. Women prone to thrush should take all reasonable measures to bring their rate down and consult a vulval clinic if they have any concerns.” The webpage should also direct women to vulval clinics[7], as these are the services where people will be trained in vestibulodynia. Training: Healthcare professionals working in thrush services inside sexual health clinics should have training, so they are aware of the link between thrush and vulval nerve damage, to reduce diagnostic delays. GP services need women's health experts who know the difference between vulval clinics and gynaecologists, as gynaecologists are not typically taught about the vulva in sufficient depth. This would help people get appropriate treatment sooner. Early diagnosis improves outcomes. Impact on my life If I had been given more information about the risk of vulval nerve damage associated with thrush and how to minimise infections, I would have been better empowered to protect myself. I cannot work full-time now. I cannot consider having children because I struggle to care for myself. My income has halved, while my outgoings on private healthcare are substantial. I live with severe medical trauma. As one of the few patients speaking publicly about vulval pain, I have been inundated with messages from women living with vestibulodynia in silence. Many have 9/10 pain. Many are suicidal and desperate for help. Thrush was often the precipitating event. Women cannot take their health into their own hands if the medical system withholds vital information. Support resources • The Vulval Pain Society • British Association of Dermatologists (information on vulvodynia and vestibulodynia) • Thrush Support References [1] InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Overview: Vaginal yeast infection (thrush). [Updated 2022 Apr 4]. Accessed online 2 February 2026. [2] NHS website. Thrush in men and women. Accessed online 2 February 2026. [3] NHS website. Common questions about clotrimazole cream, spray and solution -Brand name: Canesten. Accessed online 2 February 2026. [4] Myers, A. Candida and Alcohol: The Perfect Storm. AM MD. 21 November 2024. Accessed online 2 February 2026. [5] Vulval Pain Society. Vestibulodynia (formerly vulval vestibulitis). Accessed online 2 February 2026. [6] British Association of Dermatologists. Vulvodynia and vestibulodynia. Accessed online 2 February 2026. [7] The British Society for the Study of Vulval Disease. Clinic Map. Accessed online 2 February 2026. Share your experience Have you been affected by any of the issues raised in this blog? Perhaps you are a patient too, or a healthcare professional working in women's health? Comment below (sign up first for free) or email [email protected]

Antimicrobial resistance (AMR) is a growing threat to global health. Misuse of antibiotics, limited awareness, and gaps in infection prevention make common infections harder to treat and place patients at increased risk. The World Patients Alliance works with patient groups across regions that face rising impacts of AMR, including delayed treatment, higher treatment costs, and preventable complications. In this webinar they will focus on the shared roles of patients and healthcare providers in addressing AMR. It will open with an overview of current AMR trends and why everyday decisions by patients and provider’s matter. The session will then highlight how patient education, responsible prescribing, and effective communication can reduce unnecessary antibiotic use and support safer care. A panel discussion will bring together patient leaders and clinicians to share practical actions that strengthen awareness, prevention, and stewardship. The webinar aims to show that reducing AMR requires coordinated effort, informed choices, and strong engagement from both patients and providers. Key Objectives Explain the current burden of antimicrobial resistance and its impact on patient care. Highlight the role of patients in preventing AMR through responsible antibiotic use and infection prevention practices. Describe how healthcare providers support stewardship through accurate diagnosis, appropriate prescribing, and clear communication. Present practical examples of patient–provider collaboration that improves awareness and reduces unnecessary antibiotic use. Encourage patient organizations to promote education and community engagement that supports AMR prevention efforts. Register here.

At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That’s why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. To mark World Antimicrobial Awareness Week, which takes place every year in November, we’ve selected 18 resources related to antimicrobial resistance. Shared with us by hub members and patient safety advocates, they provide valuable insights and practical guidance about AMR. 1 Global antibiotic resistance surveillance report 2025 Antimicrobial resistance (AMR) is a growing threat to global health, undermining the effectiveness of life-saving treatments and placing populations at heightened risk, whether from common infections or routine medical interventions. This new World Health Organization (WHO) report presents a global analysis of antibiotic resistance prevalence and trends, drawing on more than 23 million bacteriologically confirmed cases of bloodstream infections, urinary tract infections, gastrointestinal infections, and urogenital gonorrhoea. 2 Short-term intermittent IV antibiotics – Understanding the issue of under delivery In this blog, Claire Davies, Clinical Therapy Manager at B. Braun Medical Ltd., explores the issue of under delivery and provides essential insights for clinicians to optimise their antibiotic therapy. 3 Tackling antibiotic underdosing: Interview with Ruth Dando, Head of Nursing for Theatres, Critical Care and Anaesthetics at BHRUHT In this video interview, Ruth Dando, Head of Nursing, Theatres, Critical Care and Anaesthetics at Barking, Havering and Redbridge University Hospitals Trust (BHRUHT) explains why antibiotic underdosing is a risk to patient safety and describes how she has implemented a change in practice to tackle the issue across BHRUHT. 4 Tackling antimicrobial resistance: How to keep antibiotics working for the next century The first WISH report on antimicrobial resistance, 'Antimicrobial Resistance: In search of a collaborative solution', was published in 2013. This report takes stock of what has emerged from the United Nations (UN) General Assembly High-Level Meeting on tackling AMR and makes six recommendations. 5 Silent Pandemic – The global fight against antimicrobial resistance (film) The film Silent Pandemic shows how countries, scientists and private initiatives around the world are networking and forming alliances, and what strategies and measures they are using to counter the advance of antibiotic resistance. 6 Why won’t my doctor give me antibiotics? Ron Daniels explains Ron Daniels, a Consultant in Critical Care, Vice President of the Global Sepsis Alliance and Chief Medical Officer of the United Kingdom Sepsis Trust, explains why doctors have to carefully manage the use of antibiotics in order to protect patients, now and in the future. 7 My involvement with Commonwealth Partnerships for Antimicrobial Stewardship Scheme (CwPAMS) in Zambia In this blog, Fiona Rees, who worked in the NHS as a hospital pharmacist for 13 years, shares her experience of working with colleagues in Zambia to improve the use of antimicrobials by using the expertise of pharmacists to help tackle AMR. 8 Reform - Powering the UK's approach to AMR: the future of AMR policy This report draws on the expert input of a roundtable held by public service think tank Reform in October 2022, to assess progress made against proposals published by Reform in 2020. It recommends actions for NHS England, the Department of Health and Social Care (DHSC) and public health departments to address the threat of AMR. 9 Antimicrobial resistance survivors: calling the world to action This Lancet article was written by a group of AMR survivors and their caregivers in order to share individual stories and perspectives on the impact of AMR. The authors highlight challenges in raising the profile of AMR, including insufficient funding, research, motivation and knowledge. They also call for meaningful patient engagement in the AMR agenda. 10 WHO: How vaccines can help prevent antibiotic resistance – Zimbabwe’s response to drug resistant outbreaks of typhoid and cholera This case study focuses on large outbreaks of antibiotic resistant strains of both cholera and typhoid in Zimbabwe and the steps taken to tackle them. It looks at a mass typhoid Vi-conjugate vaccine (TCV) vaccination campaign from February to March 2019 in nine suburbs of Harare that were severely affected by the outbreaks. 11 British Society for Antimicrobial Chemotherapy: Antimicrobial stewardship: From principles to practice This e-book provides an extensive overview of the day-to-day challenges posed by AMR, tools for setting up stewardship programmes and guidance on how to make the most of existing programmes. Its resources apply the principles of antimicrobial stewardship to a wide range of professions, populations and clinical/care settings. 12 How antibiotic underdosing affected my mum’s end of life care: An interview with Ashleigh Hughes In this interview, senior sister Ashleigh Hughes shares her personal story about the impact of antibiotic underdosing on her Mum’s end of life care. Antibiotic underdosing is a medication safety issue that has profound implications for the health service as well as individual patients, but there is currently a lack of understanding and recognition of the issue. 13 Strengthening primary health care-oriented health systems to address antimicrobial resistance: policy brief WHO policy brief on antimicrobial resistance with an emphasis on primary care. It is noted that ‘Most patient interactions occur in primary care and in the community, where an estimated 80–90% of antibiotics are prescribed. Effective primary care plays a vital role in improving the management of infectious diseases and in reducing overuse and inappropriate use of antibiotics, thus slowing the emergence of antimicrobial resistance (AMR) and ensuring the continued effectiveness of antimicrobials.’ 14 Reducing hospitalizations and multidrug-resistant organisms via regional decolonisation in hospitals and nursing homes Infections due to multidrug-resistant organisms (MDROs) are associated with increased morbidity, mortality, length of hospitalisation, and health care costs. Regional interventions may be advantageous in mitigating MDROs and associated infections. This study evaluated whether implementation of a decolonisation collaborative is associated with reduced regional MDRO prevalence, incident clinical cultures, infection-related hospitalisations, costs, and deaths. 15 What factors in the workplace enable success in antimicrobial stewardship in paediatric intensive care? Efforts to mitigate AMR prioritise antimicrobial stewardship (AMS) interventions. These interventions typically focus on deficiencies in practice and providing negative or normative feedback. This approach may miss opportunities to learn from success. In this study, the authors aimed to identify factors that enable success in AMS practices in the paediatric intensive care unit (PICU) by analysing the data obtained from interviews with staff members who had achieved success in AMS. 16 WHO: The case for investment and action in infection prevention and control Infections acquired in health care settings, including those antimicrobial resistant, cause tremendous suffering to patients, families and health workers and pose a high burden on health systems. Most of these infections are preventable with appropriate infection prevention and control (IPC) programmes and practices and basic water, sanitation and hygiene (WASH) services. This WHO document provides the evidence on the expected return in investment in and guidance for implementing and monitoring the WHO global action plan on IPC at the country level. 17 NHS England: Digital vision for antimicrobial stewardship in England Effectively tackling the challenge of AMR requires a co-ordinated and strategic approach across healthcare settings. Antimicrobial stewardship is an important element of this work. This publication outlines the functionalities that clinical digital systems need to support optimal antimicrobial stewardship in primary and secondary care. 18 Putting patients at the centre of antimicrobial stewardship in Uganda: Why meaningful patient engagement is essential to beating antimicrobial resistance Although antimicrobial stewardship (AMS) has traditionally focused on prescribers, laboratories and health facilities, evidence from Uganda demonstrates a critical reality: a large proportion of antibiotic use occurs at community and household level. Without engaging patients and communities as partners, stewardship efforts remain incomplete and unsustainable. Annet Naguudi, Regina Kamoga and Joshua Wamboga from the Uganda Alliance of Patients’ Organizations (UAPO) argue that strengthening AMS in Uganda requires placing patients at the centre of the response and highlights the strategic positioning of the UAPO to lead this shift in line with national and global priorities. #Share4safety Are you a healthcare professional looking to share your frontline insights to help improve patient safety? Have you developed a resource or tool locally that others could benefit from? Or perhaps you have an experience to share around antimicrobial resistance? Get in touch with us by emailing [email protected] Join our global patient safety community the hub is an award winning platform, bringing together people from around the world who are passionate about patient safety and reducing unsafe care. It's free and easy to join so why not sign up today and join a growing community helping to drive safer care.

This report provides an overview of keynote speeches and panel sessions at the third annual Safety For All Conference at the Royal College of Physicians in London on Tuesday 10 December 2024 The Safety For All campaign is focused on driving improvements in and between healthcare worker safety and patient safety. It seeks to highlight how poor staff safety standards and practice impact adversely on patient safety, and vice versa. The campaign champions the need for a systematic and integrated approach to improve safety for staff and patients across health and social care. Safety For All is jointly coordinated by the Safer Healthcare and Biosafety Network and Patient Safety Learning, supported by Boston Scientific and Stryker. The event was chaired by Professor Rob Galloway, Accident and Emergency Consultant at the University Hospitals Sussex NHS Trust. It was attended by over 100 members of the healthcare community, including occupational health professionals, patient safety experts, frontline staff, patients and academics. The report includes summaries of the conference’s speeches by: Professor Nicola Ranger, Chief Executive of the Royal College of Nursing Jane Murkin, Deputy Director Safety and Improvement – Nursing Directorate at NHS England. It also provides an overview of the following panel sessions across the day: Protecting lives while protecting the planet. Navigating the many faces of violence in healthcare. Caring for caregivers and patients – Mental health and safety in healthcare. Antimicrobial Resistance – Ensuring patient safety in an era of rising resistance. Implementing the Patient Safety Incident Response Framework. Throughout the speeches and panel discussions that ran across the day, there were several recurring themes: The important role of leadership in improving staff safety and patient safety. This being cited as the key to creating safer organisational cultures, modelling safety behaviours and advocating on behalf of patients and staff. The need for healthcare workers and patients to speak up in order to create a safer healthcare system, and the challenges of empowering staff to do this and organisations to create safety cultures in a system under significant strain. Communication and engagement is key – with staff and patients, and in convening people so they can collaborate for safety. Listening was mentioned throughout as being seen as a luxury, but it is essential to providing person-centred care. The challenge of sharing and spreading patient and staff safety initiatives when healthcare workers don't have time/capacity beyond trying to do the day job.

This report highlights the burden of health care-associated infections (HAIs) and antimicrobial resistance (AMR) and the related harm to both patients and health workers in care settings. It also presents an updated global situation analysis of the implementation of infection prevention and control (IPC) programmes at the national and health care facility levels, including a focus on the WHO regions. Headline points from this report include: On average, out of every 100 patients in acute care hospitals, seven patients in high-income countries (HICs), and 15 patients in low and middle-income countries (LMICs), will acquire at least one HAI during their hospital stay. Almost up to one third (30%) of patients in intensive care can be affected by HAIs, with an incidence that is two to 20 times higher in LMICs than in HICs, in particular among neonates. One in four (23.6%) of all hospital-treated sepsis cases are health care-associated and this increases to almost one half (48.7%) of all cases of sepsis with organ dysfunction treated in adult intensive care units. In 2023–2024, according to the system established to monitor the status of country progress towards the implementation of the AMR global action plan (the Tracking AMR Country Self-assessment Survey), 9% of countries did not yet have an IPC programme or plan. Only 39% of countries had IPC programmes fully implemented nationwide, with some being monitored for their effectiveness.

WHO Infection Prevention and Control Global Webinar Series Each year the WHO’s World Hand Hygiene day aims to maintain a global profile on the importance of hand hygiene in health care and to ‘bring people together’ in support of hand hygiene improvement globally. On this day, everyone, in countries and health facilities, can renew their support and promote and implement strategies and innovations to improve hand hygiene practices in health care. Objectives: To promote a shared understanding of the fact that IPC education and training should be in place for all health workers by utilizing team- and task-based strategies that are participatory and include bedside and simulation training to reduce the risk of HAI and AMR. To outline the importance of campaigning for hand hygiene and WHHD 2024 resources. To outline and describe proposed WHHD 2024 activities. To stimulate engagement with the campaign on and around 5 May 2024. Register

If you work in primary care or primary care research, this one-hour NIHR Evidence webinar is for you. This webinar will cover NIHR research that could help reduce antibiotic prescribing in primary care. Speakers will present actionable evidence on antibiotic stewardship, and safe and effective prescribing. Presentations will be followed by a Q&A session, giving you a unique opportunity to quiz the researchers on how this research could be implemented at your organisation and reflect on potential barriers and facilitators. The webinar will cover: making decisions about who is in most need of antibiotics if antibiotics are needed for children with chest infections how digital tools can help reduce antibiotic prescribing. Register