Addressing poverty and human development--synonymous with infection control.

Dr. Malani is an Associate Editor of the journal. Infect Control Hosp Epidemiol 2007; 28:1321-1322 2007 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2007/2812-0001$15.00. DOI: 10.1086/523860 As specialists in infection control and infectious diseases, issues of poverty and disease prevention have always been fundamental to our work. Beginning with the early efforts of Edward Jenner and Ignaz Semmelweis, we learned that simple, well-executed interventions can have a profound impact on prevention and control of infectious disease. Today the importance of clean water, simple sanitation, and access to basic health care remains essential; lapses in these practices result in modern day infectious diseases catastrophes, including outbreaks of diarrheal diseases, hepatitis, human immunodeficiency virus infection, and resistant tuberculosis, among others. In many ways, the concept of global health is synonymous with infection control. Infection Control and Hospital Epidemiology (ICHE) has been committed to publishing work from developing nations, precisely because it is these studies that have the most real-life value in places where most modern tools to detect, treat, and prevent infection remain out of reach because of cost and the lack of educated personnel, as well as the lack of infrastructure to deliver that care. In celebration of the integral role infection control plays in improving living standards among the world’s poorest people, we are pleased to present the following special section as our contribution to the Global Theme Issue on Poverty and Human Development organized by the Council for Scientific Editors. ICHE is one of more than 230 scientific journals simultaneously publishing new original research, reviews, editorials, and other articles addressing poverty and human development. The solutions for many of the challenges facing humans (past, present, and future) invariably include some basic aspects of infection control. In recognition of the intimate connection between poverty and the essentials of infection control, we present the following 4 selections. In choosing these articles, we focused on works that offer insight into how to improve infection control in underdeveloped areas in a manner that is sustainable, scalable, and economically feasible. Our section begins with a commentary from Allegranzi and Pittet that offers an overview of the numerous barriers to adequate infection control efforts in much of the world. Besides simple economics, the authors cite inadequate knowledge, poor staff preparedness, and the problem of “counterfeit” drugs. The implementation of minimum standards for infection control is further hindered by the lack of basic equipment, overcrowding of patients, and limited availability of surveillance data. Allegranzi and Pittet offer background on an ongoing campaign to improve hand hygiene, calling for a “systematic switch to alcohol-based hand rub at the point of care as the ‘gold standard’ practice.” In sharing the rationale for selecting hand hygiene they also detail the numerous obstacles (some unexpected) that the program has faced. Through their description of how economically viable methods to manufacture alcohol-based hand rub can be brought to the poorest areas of the world, the authors offer concrete evidence for a sustainable, scalable project to accomplish this critical component of infection control. It is encouraging that the First Global Patient Safety Challenge has already been embraced by 43 countries, more than half of which are developing nations. The deficits in fundamental skills and knowledge described by Allegranzi and Pittet are addressed in a very practical manner in the article by Caniza and colleagues. In this article, the authors share the nuts and bolts of an existing program specifically developed to address the need for infection control education in Latin America. The program emerged as a collaborative venture between St. Jude Children’s Research Hospital and several Latin American hospitals because of the observation that potentially preventable infection caused a third of deaths among pediatric hematology-oncology patients. Caniza and colleagues offer a detailed description of a 4week course consisting of lectures and hands-on laboratory and hospital experience. Results from the program’s 2005 and 2006 experiences are provided, during which 44 health care professionals received basic training in all aspects of infection control and hospital epidemiology. The plan also includes formal methods to evaluate trainees’ knowledge acquisition, an important aspect for potential funding agencies. By sharing