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.

Session 3 from the 2024 World Sepsis Congress Spotlight is now available on YouTube (embedded above) and as a Podcast on Apple Podcasts (search for World Sepsis Congress in your favorite podcast app).

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Session 3: Data, AI, and Predictive Modeling in Sepsis

New Data Initiatives for Monitoring Sepsis Globally
Paul Turner, Madihol Oxford Tropical Medicine Research Unit, Cambodia

Data Partnerships: Leveraging Insights from Emerging Infections to Fight Sepsis
Laura Merson, ISARIC, University of Oxford, United Kingdom

Can AI Models Really Improve Sepsis Outcomes?
Paul Elbers, Amsterdam UMC, The Netherlands

Developing Equitable AI for Sepsis Prediction in Children
María del Pilar Arias, Dr. Ricardo Gutiérrez Children’s Hospital, Argentina

From the Research Lab to the Wards: Designing AI Systems for Patient Safety and Clinical Usability
Chris Paton, University of Otago, New Zealand

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Sessions are released weekly on Tuesdays. The next session will be ‘How Does Hypervolemia Increase the Mortality Risk in Sepsis?’ on May 28, 2024.

You can already subscribe on either platform to be automatically notified once new sessions are available.

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Full Release Schedule

• S1: Opening Session: The Renewed Global Agenda for Sepsis – Tuesday, May 7, 2024

• S2: The Need for Early Diagnosis and Treatment of Sepsis in Surgical Patients – Tuesday, May 14, 2024

• S3: Data, AI, and Predictive Modeling in Sepsis – Tuesday, May 21, 2024

• S4: How Does Hypervolemia Increase the Mortality Risk in Sepsis? – Tuesday, May 28, 2024

• S5: The Role of Biomarkers in the Early Detection of Sepsis – Tuesday, June 4, 2024

• S6: Detecting Sepsis in the Ventilated Patient – Tuesday, June 11, 2024

• S7: Closing the Needs in Pediatric Sepsis – Tuesday, June 18, 2024

• S8: Personalized Approaches to Sepsis Management – Tuesday, June 25, 2024

• S9: Challenges and Solutions for Early Recognition and Treatment of Sepsis – Tuesday, July 2, 2024

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On May 28, 2024, the Global Sepsis Alliance is hosting a multi-stakeholder dialogue on the 2030 Global Agenda for Sepsis in Geneva, Switzerland, in parallel to the 77th Session of the World Health Assembly. The GSA is delighted to co-organize this pivotal event in cooperation with the UNITE Parliamentarians Network for Global Health (UNITE), the Virchow Foundation for Global Health, the Clinton Health Access Initiative (CHAI), the Sepsis Stiftung, Medical Women’s International Association (MWIA), and the Global Antibiotic Research and Development Partnership (GARDP).

The 2030 Global Agenda for Sepsis is the first comprehensive multi-year strategic plan, consolidating the latest evidence and knowledge on

• the human, societal, and economic burden of sepsis

• key foundations and achievements in the global fight against sepsis over the past two decades

• remaining challenges toward more effective prevention, early identification, and treatment of sepsis, and

• the way forward for reinvigorating the sepsis response at global, regional, and national levels.

Please consider that in-person participation in the event is by invitation only, but we will provide a free livestream on YouTube (embedded above), starting at 12:30h CEST (Berlin/Geneva Time) on Tuesday, May 28, 2024. You can register below to receive a reminder when the livestream starts. If you would like to join the event in Geneva in person, please contact us.

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Reminder – YouTube Livestream

Session 2 from the 2024 World Sepsis Congress Spotlight is now available on YouTube (embedded above) and as a Podcast on Apple Podcasts (search for World Sepsis Congress in your favorite podcast app).

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Session 2: The Need for Early Diagnosis and Treatment of Sepsis in Surgical Patients

Surgical Patients, Multi-Organ Failure, and the SOFA Score
David Harrison, Intensive Care National Audit & Research Centre, United Kingdom

Where Are We with Electronic Sepsis Surveillance and Early Warning Tools?
Frédéric Michard, Michard Consulting, Switzerland

Source Control – When and How?
Jan De Waele, Ghent University Hospital, Belgium

Research Priorities for Sepsis and Septic Shock in Surgical Patients
Lena Napolitano, University of Michigan School of Medicine, United States of America

The Importance of Early Clinical Suspicion in the Diagnosis of Sepsis
Halden Scott, University of Colorado School of Medicine, United States of America

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Sessions are released weekly on Tuesdays. The next session will be ‘Data, AI, and Predictive Modeling in Sepsis’ on May 21, 2024.

You can already subscribe on either platform to be automatically notified once new sessions are available.

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Full Release Schedule

• S1: Opening Session: The Renewed Global Agenda for Sepsis – Tuesday, May 7, 2024

• S2: The Need for Early Diagnosis and Treatment of Sepsis in Surgical Patients – Tuesday, May 14, 2024

• S3: Data, AI, and Predictive Modeling in Sepsis – Tuesday, May 21, 2024

• S4: How Does Hypervolemia Increase the Mortality Risk in Sepsis? – Tuesday, May 28, 2024

• S5: The Role of Biomarkers in the Early Detection of Sepsis – Tuesday, June 4, 2024

• S6: Detecting Sepsis in the Ventilated Patient – Tuesday, June 11, 2024

• S7: Closing the Needs in Pediatric Sepsis – Tuesday, June 18, 2024

• S8: Personalized Approaches to Sepsis Management – Tuesday, June 25, 2024

• S9: Challenges and Solutions for Early Recognition and Treatment of Sepsis – Tuesday, July 2, 2024

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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.

The Opening Session from the 2024 World Sepsis Congress Spotlight is now available on YouTube (embedded above) and as a Podcast on Apple Podcasts (search for World Sepsis Congress in your favorite podcast app).

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Session 1: Opening Session – The Renewed Global Agenda for Sepsis

Opening Remarks:

• Louise Thwaites, Program Chair, Asia Pacific Sepsis Alliance, Vietnam

• Niranjan ‘Tex’ Kissoon, President GSA, Canada

• Tedros Adhanmon Ghebreyesus, Director-General World Health Organization, Switzerland

• Ricardo Baptista Leite, UNITE Parlamentarians Network for Global Health, Portugal

Reinvigorating Global Action on Sepsis
Konrad Reinhart, Sepsis Stiftung, Germany

2030 Global Agenda for Sepsis | Framework
Mariam Jashi, Global Sepsis Alliance, Germany

Video Messages from Partner Organizations:

• David Ripin, Clinton Health Access Initiative (CHAI), United States of America

• Subasree Srinivasan, Global Antibiotic Research & Development Partnership (GARDP), Switzerland

• Eleanor Nwadinobi, Medical Women’s International Association (MWIA), Nigeria

Closing Remarks
Duncan Brown, Australia

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Sessions are released weekly on Tuesdays. The next session will be ‘The Need for Early Diagnosis and Treatment of Sepsis in Surgical Patients’ on May 14, 2024.

You can already subscribe on either platform to be automatically notified once new sessions are available.

---

Full Release Schedule

• S1: Opening Session: The Renewed Global Agenda for Sepsis – Tuesday, May 7, 2024

• S2: The Need for Early Diagnosis and Treatment of Sepsis in Surgical Patients – Tuesday, May 14, 2024

• S3: Data, AI, and Predictive Modeling in Sepsis – Tuesday, May 21, 2024

• S4: How Does Hypervolemia Increase the Mortality Risk in Sepsis? – Tuesday, May 28, 2024

• S5: The Role of Biomarkers in the Early Detection of Sepsis – Tuesday, June 4, 2024

• S6: Detecting Sepsis in the Ventilated Patient – Tuesday, June 11, 2024

• S7: Closing the Needs in Pediatric Sepsis – Tuesday, June 18, 2024

• S8: Personalized Approaches to Sepsis Management – Tuesday, June 25, 2024

• S9: Challenges and Solutions for Early Recognition and Treatment of Sepsis – Tuesday, July 2, 2024

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Dr. Mariam Jashi, CEO of the Global Sepsis Alliance, met Helga Fogstad, UNICEF’s new Director of Health, during her visit to the United Nations in New York on the margins of the 68th Session of the Commission on the Status of the Women (CSW68).

Dr. Uzma Syed, a Board Member of the US Sepsis Alliance and the Author of the Book “COVID-19 Viral Sepsis” joined Dr. Jashi at the UNICEF meeting and contributed substantially to the discussions.

The GSA delegation presented to UNICEF colleagues the latest estimates of the global sepsis burden, which affects 26 million women and girls every year and is responsible for the deaths of 2.9 million children under 5 and 261,000 mothers during pregnancy, childbirth, postpartum, or post-abortion. The GSA CEO further summarized the progress, achievements, remaining challenges, and how to make the sepsis response the next success story of Global Health.

Helga Fogstad, both in her current position and as the former Executive Director of the Partnership for Maternal, Newborn, and Child Health (PMNCH), reaffirmed her commitment and vision for strengthened prevention and management capacities of maternal and neonatal sepsis at national and international levels in line with the latest guidance of the WHO.

As a former UNICEF staff and senior government official, Dr. Jashi highlighted the critical role of UNICEF in reinvigorating the global response to sepsis for attaining health-related SDGs.

The UNICEF Director of Health and GSA CEO agreed to continue dialogue and closer collaboration for positioning sepsis higher on the global health agenda for women and children. Specifically, UNICEF expressed interest in contributing to the 2030 Global Agenda for Sepsis, a new multi-year strategic plan to be launched by GSA in May 2024. The parties also agreed to explore possible collaboration around the sepsis side events that GSA plans to convene on the margins of the 79th Session of the UN General Assembly and the 2024 High-Level Meeting on AMR in September 2024.

With outstanding health expertise and the prominent health portfolio of UNICEF at global, regional, and country levels, the Global Sepsis Alliance looks forward to strengthened collaboration with Director Fogstad and her colleagues to alleviate the immense human suffering from sepsis, especially among children and women living in the most vulnerable and resource-limited settings.