Dr. Mariam Jashi, CEO of the Global Sepsis Alliance joined the distinguished panelists of the First Global Self-Care Summit held in parallel with the 77th Session of the World Health Assembly in Geneva.

The summit brought together high-level policymakers and global health experts, including Dr. Mary Munive Angermüller, Vice-President and Minister of Health of Costa Rica as the keynote speaker and senior representatives of the Ministries of Health of Egypt and Malawi as co-hosts of the event as part of their ongoing work to elevate self-care in national health policies. Ministerial delegations from Guatemala, Belize, Panama, and El Salvador also attended and contributed to the discussions on how to integrate self-care into wider health plans in the Latin American region.

Upon invitation of Judy Stenmark, the Director General of the Global Self-Care Federation, Dr, Jashi spoke on behalf of the UNITE Parliamentarians Network and the Global Sepsis Alliance and emphasized the legislative and executive approaches how to integrate self-care into public health policies. She shared the stage with Dr Manjulaa Narasimhan, Acting Unit Head for Sexual Health and well-being at the World Health Organization; Professor Iain Chapple from the Institute Clinical Studies, University of Birmingham; Ellos Lodzeni - Chair, International Alliance of Patients’ Organizations (IAPO) and Wendy Olayiwola, President, Nigerian Nurses Association UK and Professional Midwifery Advocate.

At the follow-up bilateral discussions after the summit, Mariam Jashi and Judy Stenmark discussed prospects of continued collaboration between the UNITE Parliamentarian Network, the Global Sepsis Alliance, and the Global Self-Care Foundation, including how to integrate self-care in Universal Health Coverage policies and initiatives, and expressed hopes for future collaboration for the advancement of the reinvigorated global agenda for sepsis.

I came back home from a long trip and met one of my young daughters looking so lean and slim, and I was like, are you growing taller or just slimming to fashion? Her siblings said, “No Mum, she had been ill with a fever that is not responding to treatment.” My first thought was typhoid fever, because this was quite prevalent in our areas, with the lack of clean drinking water and other environmental issues.

So, off to the hospital, we went to see a doctor. After laying all her complaints, and after examination the doctor ordered some laboratory investigations which included Blood Culture. Meanwhile, she was given anti-malarial medications, antibiotics, and fluids (intravenous infusion) as she was unable to eat anything, and was dehydrated. Despite these measures, her condition worsened. She became lethargic to the point of needing support to walk. Suddenly, a realization hit me, “Could this be sepsis?”

Incidentally, all these took place at the weekend, when there’s this lackadaisical attitude and manpower shortages in all departments. The laboratory was working half–capacity, and no scientist on the ground to give us a preliminary result. I thought I could not wait until Monday before commencing her proper treatment to manage what was unfolding in front of us by the second.

I promptly returned her to the doctor and recommended starting her on broad-spectrum antibiotics to cover a wide range of possible infections. We also administered supplemental oxygen because her oxygen levels were below normal.

There was an issue with the hospital’s stock of antibiotics, so my husband had to buy the prescribed antibiotic from the pharmacy across the street. When he initially brought back the medication, I realized it was not the specific antibiotic the doctor had prescribed for her condition. I pleaded with him to go back and buy the exact one prescribed because this was a life-and-death situation, and we couldn't take any chances. 

At this point, I was becoming so anxious and getting worried that I might lose my daughter if proper care was not taken. All the family members gave the spiritual and psychological support that was needed.

Fortunately, by the second day of receiving the antibiotic, she started to recover gradually, gaining her strength and appetite, her fever dropped and at that moment, I knew we had won the battle. My sweet sixteen-year-old girl was back on her feet, and is a “Sepsis Survivor”!

Sepsis presented itself at my doorstep when I least expected it, being an advocate and a sepsis Champion, I am glad that I was able to recognize it early and gave the right drug at an early stage to combat it. In doing so, I stopped sepsis and saved a life!

Halima Salisu-Kabara

Mother to the Sepsis Survivor

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The article above was written by Halima Salisu Kabara, one of our Global Sepsis Alliance Board Members, and is shared with her explicit consent. The views in the article do not necessarily represent those of the Global Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team here at the Global Sepsis Alliance and World Sepsis Day wishes to thank her for sharing her daughter’s story and for fighting to raise awareness for sepsis.

The Global Sepsis Alliance (GSA) is pleased to announce the successful launch of the Caribbean Sepsis and AMR Alliance, at a historic event hosted by the University of the West Indies on May 26.

The Caribbean Sepsis and AMR Alliance is established under the leadership of Trinidad and Tobago and support from co-founding members from Jamaica, Barbados, and Guyana.

GSA looks forward to making a historic breakthrough in the sepsis response in the region in close collaboration with the founding members of the Caribbean Alliance and the continued leadership of Prof. Niranjan “Tex” Kissoon - GSA President.

The Caribbean Sepsis and AMR Alliance will be the 6th official regional representation of the Global Sepsis Alliance and GSA will host the official website of the Caribbean Alliance.

“A Caribbean where Sepsis is recognized early and treated effectively, thereby reducing deaths and improving patient outcomes.”

— Vision of the Caribbean Sepsis and AMR Alliance

The launch event of the Caribbean Sepsis and AMR Alliance, hosted by the Faculty of Medicine of the University of the West Indies (UWI), St. Augustine Campus on May 26, featured a series of insightful presentations from leading scholars and public health experts.

The event commenced with opening remarks from Professor Hariharan Seetharaman - Dean of the Faculty of Medical Sciences at the University of West Indies, Professor Mala Rao - Senior Clinical Fellow of Imperial College London, and a representative of EarthMedic and EarthNurse Foundation for Planetary Health.

Dr. Satish Jankie - Lecturer of the University of the West Indies, introduced the mission and objectives of the Caribbean Sepsis and AMR Alliance. The mission of the Alliance is to reduce the incidence and mortality of sepsis through improved awareness, early detection, and effective treatment.

The current state of Antimicrobial Resistance in the Caribbean was presented by Dr. Rajiv Nagessar - Medical Officer in Microbology presenting data and strategies to mitigate this growing problem.

Dr. Darren Dookhiearam - Senior Medical Officer of the Ministry of Health of Trinidad and Tobago focused on Sepsis in the Community Setting, offering insights into the Surviving Sepsis Campaign and focused on the importance of timely detection and timely antibiotic treatment.

In his presentation, Dr. Dale Ventour – UWI Lecturer in Anaesthesia and Intensive Care explored Sepsis in the Intensive Care Unit, sharing the challenges and management of sepsis and highlighting the reasons why the establishment of the Caribbean Alliance is important.

Dr. Lisa Benjamin – UWI Lecturer in Veterinary Public Health discussed the Anti-Microbial Resistance in Veterinary Medicine, highlighting the interconnectedness of human and animal health.

The program continued with a Keynote Address by Prof. Niranjan 'Tex' Kissoon, President of the Global Sepsis Alliance. Prof. Kissoon highlighted the critical importance of the unified approach to combat Sepsis and AMR worldwide and expressed his enthusiasm for the new alliance and stronger regional collaboration for combating sepsis and improving patient outcomes.

The event concluded with closing remarks from Dr. Sandeep Maharaj, Director of the School of Pharmacy at the University of West Indies. He reiterated the significance of the Caribbean Sepsis and AMR Alliance and thanked all the participants and speakers for their valuable contributions.

The Caribbean Sepsis and AMR Alliance represents a unified effort to address the burden of sepsis in the region and is one step closer to improving healthcare across the Caribbean.

The Global Sepsis Alliance (GSA) congratulates the Caribbean Sepsis and AMR Alliance on its launch and looks forward to close collaboration with the healthcare leaders in the region to address the burden of sepsis and AMR.

“No mother and child should die due to the lack of essential equipment and supplies to timely identify and timely treat Sepsis.”

— Dr. Mariam Jashi, CEO of the Global Sepsis Alliance

Today, Dr. Mariam Jashi addressed the 77th World Health Assembly, urging the global health community to prioritize the fight against sepsis.

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This Constituency Statement addresses agenda item 11.7 and is supported by the following 5 Non-State Actors: Humatem, International College of Surgeons (ICS), International Federation of Hospital Engineering (IFHE), International League of Dermatological Societies (ILDS), and the Medical Women’s International Association (MWIA).

The Non-State Actors supporting the statement called for the UN Member States and the Secretariat to prioritize the prevention, early detection, and effective management of sepsis.

Despite progress, sepsis affects 26.2 million women and 20.3 million children every year.

Sepsis widens inequality gaps, as women and children living in poverty are at higher risk.

Without a reinvigorated response to sepsis, health-related Sustainable Development Goals for maternal, neonatal, and child health cannot be achieved.

Yet, sepsis remains almost invisible in the global health architecture. Sepsis receives disproportionally low political attention and financial investments compared to its human and economic burden.

When we rightly prioritize Antimicrobial Resistance, we have to remember that the 5 million AMR-related deaths are part of 13 million sepsis-related deaths.

Therefore, we call on the Member States to urgently prioritize sepsis as recommended by the World Health Assembly Resolution WHA70.7. 

• We specifically call for the development and implementation of national action plans and policies for sepsis. 

• We urgently call for evidence-based sepsis clinical pathways for pediatric and adult populations, with a special focus on perinatal care services to ensure safe motherhood practices. 

• No mother and child should die due to the lack of essential equipment and supplies to timely identify and timely treat sepsis. Diagnostic devices, live-saving antibiotics, oxygen, and treatment facilities for sepsis-related organ dysfunction should be universally accessible. 

• Sepsis literacy should be enhanced, and we shall further strengthen vaccination and water and sanitation practices as key elements of sepsis prevention. 

• Finally, public and private stakeholders should prioritize research and development for better quantity and quality of data, and novel solutions for prevention, early detection, and effective treatment of sepsis.

Amazing sepsis survivors and Global Sepsis Alliance (GSA) representatives Shahrzad Kiavash and Krista Bracke had the great honor to personally meet Dr. Tedros, Director General of the World Health Organization (WHO), at the Walk the Talk: Health for All Challenge in Geneva on Sunday, May 26. Organized by WHO for the fifth year in a row, the event brought together thousands of health advocates to the start of the 77th World Health Assembly. A unique opportunity to raise awareness of the sepsis challenge.

Shahrzad Kiavash is a Swedish triathlete and Krista Bracke a Belgian journalist. They both survived sepsis some years ago but with irreversible consequences such as a double below-knee amputation. 

Shahrzad and Krista had the opportunity to briefly stress the global burden challenge of sepsis whereas Dr. Tedros highlighted again his support to the sepsis cause. 

“This recognition of sepsis by Dr. Tedros is of such importance to all sepsis survivors and their families. As not being taken seriously (even by certain health professionals) is devastating. ”

— Krista Bracke

“The consequences of surviving a sepsis can be truly heavy, both for the survivors and the loved ones. To be able to address the burden of sepsis to Dr. Tedros was of great importance. ”

— Shahrzad Kiavash

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The GSA is leading the development of the first multiyear global strategy for sepsis which will be an inclusive and participatory process in which sepsis survivors and their families will have an important role to play. The Alliance is looking forward to launching this strategy, the 2030 Global Agenda for Sepsis, on September 13th at World Sepsis Day, in close partnership with the WHO, other UN-agencies and strategic partners at the GSA.

In parallel to the 77th Session of the World Health Assembly on May 28, 2024, the Global Sepsis Alliance will host a multi-stakeholder dialogue on the 2030 Global Agenda for Sepsis.

“The face behind every AMR-related death is a face of a child, a woman or man, suffering and dying from sepsis”

— Dr. Mariam Jashi, CEO of the Global Sepsis Alliance

Upon the invitation of Mr. Dennis Francis, President of the United Nations General Assembly, Dr. Mariam Jashi addressed the multi-stakeholder hearing in New York in preparation for the UN General Assembly High-Level Meeting on Antimicrobial Resistance (AMR). Dr. Jashi was invited as a panelist on adequate, predictable, and sustainable financing for AMR.

The CEO of the Global Sepsis Alliance congratulated the global health leaders for positioning antimicrobial resistance on the high-level political agenda, ensuring that over 170 counties have developed national action plans and that AMR has been prioritized in One Health Quadripartite agreement for the health of people, animals, and ecosystems.

At the same time, Dr. Jashi called the UN Member States and multiple stakeholders to ensure that in every political dialogue and decision-making process, AMR is discussed as part of broader global health challenges that require holistic solutions.

 On the necessity to urgently synergize sepsis and AMR policies and action, Dr. Jashi noted the following:

A brief video on the sepsis statement

 “The Global Sepsis Alliance is delighted that national and global health authorities and increasingly the agriculture and environmental sectors recognize that almost 5 million deaths are associated or attributed to antimicrobial resistance. However, these 4.95 million AMR-related deaths are only part of the 13.7 million sepsis-related deaths every year. The face behind every AMR-related death is the face of a child, a woman, or a man, suffering and dying from sepsis. Therefore, we need to urgently prioritize synergies between the AMR and sepsis agenda at global, regional, and national levels, and ensure that the political declaration of the High-Level Meeting on AMR adequately positions sepsis”

Furthermore, Dr. Jashi stressed that AMR should be part of a more comprehensive agenda for health-related SDGs, Universal Health Coverage, and the Pandemic Accord. “We can find better solutions for AMR only through extending UHC to at least 1 billion more people globally and building more resilient health systems” noted the GSA CEO.

Mariam Jashi concluded that a truly holistic and integrated approach to AMR, including through the One Health Quadripartite agreement, calls for maximum synergies and minimal fragmentation. Therefore, the High-Level Political Declaration for AMR should reflect the critical linkages of AMR with Universal Health Coverage, the Pandemic Accord, and the need for reinvigorated action for sepsis at global, regional, and national levels. Said political declaration should also call for adequate and sustainable funding from national governments, the stronger role of Parliamentarians in policy and budget decisions, and additional resources from official development assistance, public-private partnerships, and innovative financing solutions.

Regarding financial sustainability, Dr. Jashi discussed 5 major platforms for leveraging domestic resources for a multi-sectoral response to AMR.

1. First, in line with the Quadripartite agreement, national governments should establish multi-sectoral coordination mechanisms with the engagement of health, environment, agriculture, and finance ministries. Joint inter-ministerial work on costing national action plans for AMR will be key for reaching a consensus on the national investment cases and securing sufficient and sustainable domestic funding.

2. Second, Parliamentarians should be more actively engaged in the global health architecture, including AMR. Parliamentarians are direct representatives of local constituencies, they are the ultimate decision-makers to approve national laws and budgets and can hold governments accountable for execution and results. Therefore, legislative platforms, including parliamentary hearings and budget approval processes should be utilized to secure adequate accountability and funding.

3.  Third, even if donor governments and international finance institutions contribute to the overall pool of multilateral funding and international development aid, performance-linked loans and grants can catalyze additional domestic investments for AMR. For example, the World Bank can prioritize AMR and sepsis-related key performance indicators in their budget support loans as the conditionalities for initial or subsequent tranches.

4.  The Global PPPs, such as GAVI or the Global Fund, can not only integrate AMR and sepsis responses under the HSS portfolios but eventually catalyze additional domestic funding from national governments through phasing out and full transition from donor support.

5.  Finally, innovative financing mechanisms, such as global or national solidarity taxes or voluntary solidarity platforms can leverage additional funding solutions. For example, the Oxygen initiative of UNITAID directly responds to the clinical management needs of AMR and sepsis both for routine UHC programs and the Pandemic Response.

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The complete video recording of the meeting, including the interventions of Dr. Jashi, can be accessed at minute 35:21.

When I was 16, I was diagnosed with stage IIIa Hodgkin's disease. What followed was surgery, chemotherapy, and radiotherapy. As part of the treatment, my spleen had to be removed as well as many lymph nodes. I knew I didn't have a strong immune system and should take care of myself. It wasn't until many years later that I saw on TV that you should get an asplenia emergency passport if you have a missing spleen, which I did. But paper doesn't blush and the longer I was well, the less I believed that something bad could happen to me ... and I had already cheated death once.

After being on short-time work in 2020 and 2021 due to the coronavirus pandemic, I decided to reorganize my professional life. I quit my job then and got another one on a Swiss mountain pasture for 9 weeks. I planned to do a lateral entry to work in a cheese dairy on a small farm as milking cows and making cheese in the seclusion of the mountains had always been a childhood dream.

The hut is situated at around 1800m with a fantastic panorama. Running water and electricity is for milking and making cheese only. To keep the hut warm you have to chop wood and always keep the heating oven running. For July the weather was too wet and too cold. Milking and cheese-making were shared between me and the alpine farmer.

Given my medical history, I carry all my medical records and important medications with me at all times. It was after 4 weeks on the alpine pasture that I suddenly developed severe swallowing problems on a Thursday morning after milking the cows. I couldn't eat or drink anything at breakfast. Despite the swallowing problems, I did some alpine meadow maintenance during the day and in the evening, back in the barn milking, wrapped up in warm clothes but still freezing. This is when the farmer sent me straight to bed with 2 hot water bottles, throat lozenges, and a scarf ... It felt like I wore my entire wardrobe in bed so I wouldn't freeze.

On Friday, the swallowing was just as bad and I remember being surprised that the pain was just as intense. Then there were the night chills. I spent all of Friday in bed and didn't eat or drink anything. The alpine farmer checked on me from time to time, and we both hoped I'd get better if I just rested enough.

When I wasn't feeling any better on Saturday, we considered driving down to the valley in the afternoon with the nearest hospital being 2 hours away.

At one point, I wanted to get up to fire up the heating oven when I realized that my upper left arm was hurting and I could no longer stand on my left leg. I dragged myself on all fours into the next room to the oven and then dragged myself back to bed, completely exhausted.

I don't know at what time I fell asleep again, and what happened next, I only know from the narrative.

When the farmer and the visitor, who had come to the pasture on Friday, decided to take me to the hospital on Saturday, I was already unconscious with a change of character. That is why they called the Swiss air rescue service Rega in the evening, which flew me by helicopter to the cantonal hospital in Lucerne.

In the shock room, the doctors immediately took care of me, contacted my husband as I was unresponsive, and performed one exclusion procedure after another. The Rega doctor had admitted me to hospital with suspected sepsis, among other things, but as my results were inconclusive, the search had to be continued. I don't know much about the 5 days in intensive care, just scraps of memory. On day 6, I was transferred to the cardiology ward. For a long time, I didn't understand what had happened or what was going on with me. It wasn't because of the doctors, but because my head couldn't take it in.

It turns out I had caught Streptococcus pyrogenes on the mountain pasture. This caused inflammation of the aorta and mitral valve (endocarditis). The embolisms spreading through the body caused several strokes and necroses on the left upper arm, the left hip, the fingers, and both feet. To save the massive necroses on both feet and both lower legs, the feet, and knees were operated on and flushed three times within 1.5 weeks. Many examinations such as MRIs, CTs, and heart echoes were carried out, which I can no longer remember. I was given antibiotics and strong painkillers for 4 weeks and had to lie in bed for 5 weeks.

It was only when the levels of inflammation were back in the normal range, and the doctors were able to justify it, that an ambulance took me back to a clinic in Munich. There I stayed for another 2 weeks for observation and further wound checks, followed by 7.5 weeks of rehab, IRENA program, physiotherapy and psychotherapy, stays in the pain clinic, and constant check-ups with various doctors. I had further operations on both feet in December 2022 and October 2023.

Due to the many necrosis scars and surgeries, as well as being in a cast for so long, I have to relearn everything that has to do with my feet. Everything! Things that everyone else does so naturally are a mental effort for me, nothing happens automatically. With everything I do comes pain, numbness, and tightness in my toes, ankles, and feet. Also, my cardiac output is reduced and I have been put on a cardio training program designed specifically for me.

Every day I am thankful to be able to stand on my feet and walk. I am thankful for my life and the many helping hands that have made it possible.

I never considered sepsis an issue, even though it's on my emergency asplenia pass. It has just not been on my radar. But now I ask myself questions like: How can I protect myself? How can I strengthen my immune system? How can I trust my body again? How can I become mentally stronger?

I don't think I'm the only one who feels this way. Support during the acute phase is important, but support afterward is just as important. Because I got sick in Switzerland and had to terminate a lot of things here in Germany, it wasn't easy to get back into the German system. Even though I'm back in the system now, I often feel like I have to justify myself because my pain, limited mobility, lack of concentration, reduced performance, and anxiety are not visible.

I began to write a book to help me come to terms with what had happened. A book that tells my story, but also includes the views of my family and medical staff. I want to show the different perspectives and how I managed to motivate myself again and again to cope better with sepsis and its consequences.

I hope that my book "Überlebenskampf Sepsis" ("Surviving Sepsis") will reach the general public and that the topic of sepsis will become more visible and come out of its shadowy existence. I want to give courage to the people affected, confidence to their relatives, and share our perspective with the medical staff. We are all fighting the same battle, albeit on different sides, but together we can support each other.

I am very grateful to my husband, who was with me in Switzerland during the acute period, took care of all the bureaucracy, and has always been a great support to me. He also kept my parents and sister up to date at all times. This was a difficult time for all of them.

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The article above was written by Heike Spreter-Krick and is shared with her explicit consent. The views in the article do not necessarily represent those of the Global Sepsis Alliance. They are not intended or implied to be a substitute for professional medical advice. The whole team here at the Global Sepsis Alliance and World Sepsis Day wishes to thank Heike for sharing her story and for fighting to raise awareness for sepsis.

Every year on May 5th, the World Health Organization (WHO) – in partnership with national governments and global health players – marks World Hand Hygiene Day, emphasizing the critical role of hand hygiene in preventing infections, including sepsis.

The Global Sepsis Alliance supports the WHO’s campaign and this year’s slogan, "Why is sharing knowledge about hand hygiene still so important?” Because it helps stop the spread of harmful germs in healthcare. We reiterate that hand hygiene plays a critical role in the prevention of infections, and therefore of sepsis, both in community and healthcare settings.

The World Hand Hygiene Day 2024 campaign promotes knowledge and capacity building of health and care workers through innovative and impactful training and education, on infection prevention and control, including hand hygiene.

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Save-the-date for “WHO Infection Prevention and Control Global Webinar”

As part of this critically important campaign, the World Health Organization (WHO) will host the “WHO Infection Prevention and Control Global Webinar” on May 6th, from 2:00 PM to 3:30 PM CEST.

We invite all healthcare professionals, caregivers, policymakers, and other stakeholders to participate in the webinar and address hand hygiene, infection prevention and control, and sepsis holistically as pillars of a coordinated strategy.

We encourage you and your organization to support World Hand Hygiene Day and prevent sepsis at the healthcare and community levels.

For more information about the campaign and the webinar please see the links and documents below.