Executive summary

According to World Health Organization (WHO), Antimicrobial Resistance (AMR) is:” the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.”

AMR presents a significant threat to human health, food, security and development today. If the current rate continues, the WHO anticipates that 10 million people will die (more people than currently die from cancer) and 66 trillion pound would be needed to tackle AMR by 2050. World leaders have agreed that tackling AMR will require addressing both health and agriculture concerns with a focus on prevention. Improving infection prevention and control (IPC) and water, sanitation, and hygiene (WASH) is one of the five objectives in the World Health Organization’s (WHO) AMR Global Action Plan. Nowhere is reducing infection more important than in health care facilities. Joint, immediate action to address Infection prevention and control (IPC) and WASH is essential.

Water, sanitation and hygiene (WASH) in healthcare facilities are the cornerstone of IPC according to WHO. According to the WHO, the implementation of WASH measures could reduce the demand for antibiotics and therefore curb their overuse in specific categories by as much as 60% in low and middle-income countries.

Whilst basic measures such as contact precautions, hand washing, and proper cleaning can play a significant role in preventing the spread of bacteria between patients they are often neglected.

As the spread of AMR is often unnoticed, each patient should be treated as if they are carrying drug-resistant bacteria.

At Mott MacDonald, we’re leading the way, working across countries and sectors to help our clients understand and respond to the threat of AMR through a programme of technical and professional excellence activities.

There are many published papers, websites, NGO’s, notes and blogs that are highlighting the danger of AMR and suggesting prevention incentives. This report will analyse the incentives, from an Engineering and Facilities Management perspective, that could be put in place at Design, Construction and Operation phase of a healthcare building.

Please see below figure showing the stages where Engineers and FM advisors could make an input by introducing AMR preventive measures into the work they carry out.

Figure 1.1: Stages where Engineers and FM advisors could make an input

Source: Mott MacDonald