The case for investment

and action in infection

prevention and control
 Acknowledgements
The development of the investment case was coordinated by the Department of Integrated Health Services
(IHS), Universal Health Coverage and Life Course Division of the World Health Organization (WHO). Benedetta
Allegranzi (Department of IHS) coordinated the overall development process and led the writing of the
document. Peter Bischoff (infection prevention and control (IPC) consultant, Department of IHS) contributed
to the writing, and Ece Özçelik (Organisation for Economic Co-operation and Development (OECD), Paris,
France) contributed to the content of this document.

Ece Özçelik (OECD, Paris, France) and Aliénor Lerouge (OECD, Paris, France) carried out the statistical
analyses for part of the data presented in this investment case.

The following WHO staff and consultants contributed to the development of this document: Melanie Bertram
(Department of Delivery for Impact, Division of Data Analytics and Delivery); Ana Paula Coutinho Rehse (WHO
Regional Office for Europe, Copenhagen, Denmark); Rudi Eggers (Department of IHS); Zhao Li (WHO Regional
Office for the Western Pacific, Manila, Philippines); Margaret Montgomery (Department of Environment,
Climate Change and Health, Healthier Populations Division); Paul Rogers (Department of IHS); Giovanni Satta
(Department of IHS).

WHO extends its gratitude to the following external reviewers of this investment case: Alessandro Cassini
(Cantonal Service of Public Health, Geneva, Switzerland); Michele Cecchini (OECD, Paris, France); Christine
Fears (Healthcare Infection Society, London, United Kingdom).

All external experts mentioned completed a declaration of interest form in accordance with the WHO
declaration of interests’ policy for experts. No potential conflicts were identified .

Acknowledgements of financial and other support

Core funds from WHO headquarters supported the development and publication of the investment case
document.

WHO/OECD unpublished data reported in this document come from a study on cost-effectiveness of IPC
interventions funded by the Centers for Disease Control and Prevention, USA. All technical and funding
inputs from institutions and individuals from the United States of America preceded 20 January 2025.

© World Health Organization 2025. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.

Suggested citation. The case for investment and action in infection prevention and control. Geneva: World Health
Organization; 2025. [Link]

Design by Maraltro.

2
Key messages
◆ 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 (1).

◆ Most of these infections are preventable with appropriate infection prevention and control (IPC)
programmes and practices and basic water, sanitation and hygiene (WASH) services. Improving
IPC and WASH saves lives and yields high economic gains (2).

◆ At the 77th World Health Assembly, all countries adopted the WHO global action plan and
monitoring framework 2024–2030 (3).

◆ This 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 (3).

◆ Improving IPC and WASH through the fulfilment of at least the WHO minimum requirements for
IPC (4) should be an urgent priority for all countries in order to provide minimum protection and
safety to patients, health workers, as well as families and visitors to facilities, and achieve targets
for health care-associated infections’ (HAIs) and AMR reduction (3, 5).

◆ Action and investment in IPC and WASH by international key players, donors and non-
governmental organizations, can make a huge difference both at the global level and in support
to countries and facilities, in particular where resources and expertise are limited. WHO is in
the position of leading and coordinating these efforts and will strongly support country efforts
directly.

3
 Doctors and nurses during a trachoma operation
at a hospital in Kakuma, Kenya. © WHO / NOOR /
Sebastian Liste

1. The harm and burden caused by

infections acquired in health care
Every year, around the world hundreds of millions HAIs also pose a high organizational and economic
of patients and health workers are harmed by burden for health systems (2).
preventable infections acquired during health care
delivery, including those resistant to antimicrobials. According to a key review published in 2005, low-
- Family members and visitors to health care facilities and middle-income countries (LMICs) have an HAI
can also be affected. These infections, known as frequency that can be two to 20 times higher than
HAIs, can be acquired during health care delivery at in high-income countries (HICs) and bear a heavier
any point in time and spread through outbreaks in mortality burden due to HAIs than HICs (1).
health care settings (1).
Fig. 1 provides an overview of relevant data on the
HAIs cause preventable suffering, prolong the harm and burden caused by infections and AMR
duration of hospital stay, cause complications such acquired in health care. A comprehensive review and
as sepsis and other conditions which can lead to further details on this issue are presented in the 2024
disabilities and premature death, and force health WHO global report on IPC (1).
workers to stay off work (1).

4
Fig. 1. The harm and burden caused by infections acquired in health care

      

    
  





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Abbreviations: DALYs, disability-adjusted life years; EU/EEA, European Union/European Economic Area; HAIs,
health care-associated infections; HICs, high-income countries; LMICs, low- and middle-income countries
a
Global estimates based on key review and WHO report published in 2011; EU/EEA estimates based on 2012–2023
data from the European Centre for Disease Prevention and Control point prevalence survey.
b
One DALY represents the loss of the equivalent of one year of full health. DALYs for a disease or health condition
are the sum of the years of life lost due to premature mortality (YLLs) and the years lived with a disability (YLDs)
due to prevalent cases of the disease or health condition in a population.
c
Based on 2011–2012 data from the European Centre for Disease Prevention and Control point prevalence survey.
d
Based on 2015 data from the European Antimicrobial Resistance Surveillance Network (EARS-Net).
e
Adjusted for purchasing power parity.
Sources: (1, 6-11); WHO/OECD, unpublished data (for these calculations a modified version of the OECD
Strategic Public Health Planning for infectious diseases model was used. Based on: OECD; 2023 (http://
[Link]/amr-doc/)).

5
 2. IPC as an effective solution
Reasons for investing in IPC

IPC ensures patient and health workers’

1 safety and quality of care

IPC directly improves health outcomes

2 and saves lives

IPC reduces health care costs and generates

3 economic gains

6
 IPC ensures patient and health workers’
1 safety and quality of care

IPC is a practical, evidence-based set of measures infrastructure (such as ventilation systems);

which prevents patients, health workers, and WASH; and waste management services are in
visitors to health care facilities from being harmed place and considered a core component of IPC
by avoidable HAIs. programmes.

Examples of key IPC measures are hand hygiene, IPC occupies a unique position in the field
standard precautions, personal protective of patient and health workers’ safety, as it is
equipment, environmental hygiene, disinfection universally relevant to every health worker
and sterilization, injection safety, aseptic and patient, at every health care interaction.
practices for handling invasive devices. To enable Therefore, it significantly contributes to achieving
IPC practices, it is crucial to ensure that adequate high-quality care for all.

IPC directly improves health outcomes

2 and saves lives

It is proven that a large proportion of HAIs, and neonatal care, preventing maternal and
including those caused by antimicrobial-resistant neonatal sepsis and associated deaths (18). It
and epidemic-prone pathogens, can be prevented supports efforts to address priority global health
with improved IPC practices and basic WASH challenges, such as preventing the transmission
services (12-14) (Fig. 2.1). of the pathogens that cause tuberculosis and
hepatitis in health care settings (19, 20). It also
The most effective approach to reduce specific
prevents deadly antimicrobial resistant infections
HAIs at the point of care, is to use multimodal
in fragile and immunocompromised patients such
improvement strategies (MMIS)1; success is
as those affected by AIDS and cancer (20, 21).
usually higher when the intervention is supported
by a national or subnational coordination Having in place specific IPC standards such as
mechanism (by the Ministry of Health or a specific IPC nurses with dedicated time, alcohol-based
network) (15-17) (see Box 1 in section 5). handrub dispensers at point of care, single rooms,
and implementing IPC MMIS correlate with lower
IPC improves health outcomes in critical priority
prevalence of antibiotic-resistant bacteria in
areas. For example, good IPC practice creates
health care facilities in EU/EEA (8).
the conditions for clean and safe maternal

1
The WHO multimodal improvement strategy is a core component of IPC programmes and comprises the following five elements:
system change; training and education; monitoring and feedback; reminders and communications; and a safety climate/culture change.
In other words, the strategy involves building the right system, teaching the right things, checking the right things, selling the right
messages, and ultimately ”living” IPC throughout the entire health system.

7
 Fig. 2.1. Effects of IPC interventions in health care facilities



 
   
 
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Abbreviations: AMR, antimicrobial resistance; HAI, health care-associated infection; IPC, infection prevention and
control; LMICs, low- and middle-income countries; MMIS, multimodal improvement strategies; WASH, water,
sanitation and hygiene
a
Based on systematic reviews including studies conducted from 2005–2016.
Sources: (12-14, 22); WHO/OECD, unpublished data (for these calculations a modified version of the OECD
Strategic Public Health Planning for infectious diseases model was used. Based on: OECD; 2023 (http://
[Link]/amr-doc/)).

8
 IPC reduces health care costs and generates
3 economic gains

Landmark institutional reports by OECD, World Economic evaluation of interventions to prevent

Bank and WHO demonstrated the potential high the spread of specific high-impact diseases such as
societal return on investment from appropriate tuberculosis, in health care facilities also showed
IPC implementation and enforcement (Fig. 2.2). high cost-effectiveness, with a low implementation
In particular, according to the OECD analysis investment (24).
of 34 OECD and EU/EEA countries, enhancing
environmental hygiene and hand hygiene in Rapidly increasing access to personal protective
health care facilities generates the highest equipment, combined with IPC training and
health and economic gains among 11 policy education, during the first six months of the
interventions against AMR (2). Productivity gains COVID-19 pandemic, would have led to a
are likely to be made in all settings, and health significant reduction of infections among health
service cost savings are substantial in high and workers and the associated costs for treatments
upper-middle income countries. and loss of productivity (25).

Scientific evidence has demonstrated cost- According to the World Bank, investing in infection
effectiveness for hand hygiene, environmental prevention worldwide would require only a
hygiene, multimodal strategies to implement fraction of the costs considered necessary to
IPC interventions, including screening of high- minimize and contain AMR (Fig. 2.2). The cost of
risk individuals for colonization with resistant inaction would be dramatic, leading to losses
bacteria and using local treatments for eliminating 30 times the amount considered in the (annual)
them. However, there is scarcity of evidence from investment to contain AMR (26).
lower middle- and low-income countries (23).

Fig. 2.2. IPC return on investment – part 1



 
  
 
     
      
 

Abbreviations: AMR, antimicrobial resistance; IPC, infection prevention and control.

Source: (25).

9
 Fig. 2.2. IPC return on investment – part 2a
Within a package of 11 "One Health" interventions, hand hygiene and environmental
hygiene in health care facilities are the most effective and cost-saving investment to
reduce AMR, based on model for 34 OECD members and EU/EEA countriesb.
Impact on mortality Economic impact
Avoided deaths per year Total gains per year (US$)
14 000

12 000

10 000

8000

6000

4000

2000
0B 5B 10 B 15 B

0
Environmental hygiene
Hand hygiene
Antimicrobial stewardship
Delayed prescribing
Scale up use of RDTs
Media campaigns
Health workers’ education
Financial incentives
Resistant infections Vaccination Savings in health expenditure
Susceptible infections Productivity gains
Safe food handling
Farm biosecurity

  
  

 
   
 


   
  
   

Globally, IPC interventions 

implementation in health 
care facilities, using MMIS 
and national coordination 
mechanisms could yield 
annually:  

Abbreviations: EU/EEA, European Union/European Economic Area; IPC, infection prevention and control; MMIS,
multimodal improvement strategies; OECD, Organisation for Economic Co-operation and Development; RDTs, rapid
diagnostic tests.
a
In all instances “US$” is mentioned, it refers to 2020 United States dollar, adjusted for purchasing power parity.
b
Estimates for the return on investment are the result of the total annual savings in healthcare expenditure and
productivity gains in the 34 countries produced by the policy divided by the total cost of implementing the policy
between 2023 and 2050.
c
Due to greater participation in the workforce and enhanced economic productivity.
Sources: (2); WHO/OECD, unpublished data (for these calculations a modified version of the OECD Strategic Public Health
Planning for infectious diseases model was used. Based on: OECD; 2023 ([Link]

10
 A nurse is washing her hands before surgery in a
hospital in Moscow, Russia. © WHO / Sergey Volkov

3. WHO’s leading role in the field of IPC

In the last decade, WHO has taken a leading role in the field of IPC, including WASH (Fig. 3.1). A
in providing strategic and technical guidance, number of international partners have exceptionally
developing standards and practical tools, monitoring contributed to these efforts and have taken powerful
implementation of IPC programmes, supporting action (27).
countries, and coordinating international action

11
 Fig. 3.1. Milestones of this work in support to country efforts

Core components for IPC programmes: evidence- and

1. IPC PROGRAMMES
and all relevant programme linkages expert consensus-based guidelines for developing
2. GUIDELINES 3. EDUCATION 4. SURVEILLANCE
6. MONITORING,
AUDIT AND
effective IPC programmes, including six core
components recommended at the national and facility
AND TRAINING
FEEDBACK

ENABLING ENVIRONMENT
7. WORKLOAD, STAFFING AND BED OCCUPANCY

8. BUILT ENVIRONMENT, MATERIALS AND EQUIPMENT levels and two additional core components specific to
5. M
U LT I
M O D AL S TR ATE G
IES
the facility level, including WASH (28).

Minimum requirements for IPC programmes:

standards that should be in place in all countries and all
health care facilities, based on the IPC core components
(4).

WASH FIT: a risk-based, quality improvement tool for

health care facilities, covering standards and indicators
of WASH and health care waste management services,
and selected aspects of energy, building and facility
management (29).

Framework and toolkit for IPC in outbreak

preparedness, readiness and response: a practical
framework of actions and a toolkit to assist in the
development of local contingency or action plans for
strengthening IPC outbreak preparation, readiness and
response at the national and facility level (30, 31).

Surveillance of HAI: comprehensive guidance to

design and implement effective surveillance systems
to measure the burden of HAI and take action for its
prevention. It also includes WHO HAI surveillance case
definitions for use in low-resource settings (32).

WHO Global IPC Portal: a WHO resource that supports

countries to make situation analysis, track progress
and make improvements to IPC programmes and/
or activities at the national and facility levels, in
accordance with WHO standards and associated
implementation materials (33).

12
 Portrait of a family nurse at a district primary
health care centre in Rudaki, Tajikistan. © WHO /
Lindsay Mackenzie

4. Actions we can take in countries and

health care facilities
Why action is urgent
Many countries implemented the WHO and other for their effectiveness (36). Fewer than one half
recommendations and implementation approaches (44%) of countries had a dedicated IPC budget for
(1, 34, 35), showing that nations which treat IPC and implementing the national programme and plan
WASH as critical health priorities, can make progress (1). Furthermore, as of 2024, only 6% of countries
and protect their patients and health workforce, met all the WHO minimum requirements for IPC
while saving money. programmes at the national level and in a sample of
5537 health care facilities from 92 countries, 15.8%
However, many gaps and challenges still exist in IPC met all WHO IPC minimum requirements (1) (Fig.
implementation (1). 4.1). A comprehensive situation analysis of IPC at
the national and health care facility level as well as
In 2023, 9% of countries did not have an IPC by region and income level is available in 2024 WHO
programme or plan yet, and only 39% of global report on IPC (1).
countries had IPC programmes fully implemented
nationwide, with some of them being monitored

13
 Fig. 4.1. Percentage of the WHO minimum requirements for IPC, met at
the national and facility level, worldwide

   

 
 

  




  

      

  
     

Abbreviations: IPC, infection prevention and control; WHO, World Health Organization.
Source: (1).

The documented harm caused to patients and In 2022, two out of five (43%) health care facilities
health workers by weak or inappropriate IPC worldwide lacked hand hygiene services at the point
policies and practices calls for urgent and sustained of care or in toilets, covering 3.4 billion people in
action. It is essential that health workers have the need of using them (37).
services and equipment to safely carry out the best
IPC practices. This includes appropriate WASH and
waste services, as a fundamental part of the so
called “built environment” (core component 8) (28).

14
Actionable strategies and plans
Building upon the lessons learned from the accelerated efforts to highlight the importance of
COVID-19 pandemic and other outbreaks and higher IPC in the global and national health agenda and
awareness about HAIs and AMR, WHO, international committed to stronger action.
partners and Member States have recently

Member States proposed and adopted a resolution

Global on IPC at the 75th World Health Assembly (38) in
strategy 2022, aimed at strengthening IPC programmes
on infection across the health system at the national,
prevention
and control subnational and/or facility levels, and requesting the
development of a global strategy, action plan and
monitoring framework on IPC.

One year later, the first ever WHO global strategy

(39) was approved by all Member States, and served
as the backbone of the 2024–2030 WHO global
action plan and monitoring framework (3) which
was adopted by all countries at the 77th World
Health Assembly (40) in May 2024.

The WHO global strategy (39) on IPC indicates eight implementation of each of these strategic directions
strategic directions as being critical to achieve and track and report progress between 2024 and
improvement in IPC (Fig. 4.2). The global action 2030, at the global, national, sub-national and
plan and monitoring framework on IPC describe facility level (3).
actions, indicators and targets to achieve effective

IPC integration and coordination

Among all strategic directions, IPC integration Therefore, the collaboration, alignment and mutual
and coordination is paramount for the success support with other programmes2 are critical to
of IPC programmes. While IPC is a specialized avoid duplications and amplify achievements. For
area of work that requires specific expertise and example, the WHO/UNICEF Global Framework for
dedicated human and financial resources, it is a Action on Universal WASH, Waste and Electricity
cross-cutting area that contributes substantially to Services in all Health Care Facilities to Achieve
the achievement of other programmes’ objectives Quality Care 2024–2030 (41), aligns directly with the
and it benefits from active synergies with them. IPC global action plan and can accelerate IPC efforts.

2
Including – but not limited to – AMR, quality of care, patient safety, WASH, occupational health and health emergencies, as well as HIV,
TB, hepatitis, maternal/child health and surgical care, and other programmes.

15
 Fig. 4.2. Strategic directions as the overall guiding framework
of the WHO global strategy on IPC

Political
Active IPC
commitment
programmes
and policies

IPC knowledge
of health and care
IPC integration workers
and coordination and career
pathways for IPC
professionals

Data Advocacy and

for action communications

Collaboration
Research
and stakeholders’
and development
support

Abbreviations: IPC, infection prevention and control.

Source: (39).

16
 Committee A meeting for the fourteenth time
during the seventy-seventh World Health Assembly
in Geneva, Switzerland. © WHO / Pierre Albouy

5. What we can achieve between now

and 2030
The WHO global strategy (39) and action plan on IPC (3) are driven by an inspirational and ambitious vision:

By 2030, everyone accessing or providing health care is safe from associated infections.

The WHO 2024–2030 global action plan and Member States agreed upon a number of indicators
monitoring framework outline clear pathways to to be monitored to track progress towards attaining
achieve and demonstrate this vision (3). core targets by 2030 (Fig. 5.1 and Table 5.1).

Fig. 5.1. WHO GAP/MF core target as proportion of countries meeting all
WHO IPC minimum requirements for IPC programmes at the national level

Minimum Requirements
2024 2026 2028 2030
30% 60% 90%
Abbreviations: GAP/MF, global action plan and monitoring framework; IPC, infection prevention and control.
Source: (3, 4).

17
 Within the WHO monitoring framework (3), eight core These targets can mostly be monitored using existing
targets have been prioritized to be achieved at the monitoring systems and the WHO global report 2024
national level and four at the facility level (Table 5.1). provides baseline data for most of them (1).

Table 5.1. Core targets of the IPC MF at the global and national level.
Eight core targets at globala level
1. Increase of proportion of countries with a costed and approved national action plan and monitoring framework
on IPC (> 80% by 2030)
2. Increase of proportion of countries with legislation /regulation to address IPC (> 80% by 2030)
3. Increase of proportion of countries having an identified protected and dedicated budget allocated to the national
IPC programme and action plan (> 90% by 2030)
4. Increase of proportion of countries meeting all WHO IPC Minimum Requirements for IPC programmes at national
level (through WHO IPC portal) (> 90% by 2030)
5. Increase of proportion of countries with national IPC programmes at Level 4 or 5 per SPAR 9.1 and Level D and E in
TrACSS (> 90% by 2030)
6. Increase of the proportion of countries with basic water (1), sanitation (2), hygiene (3), and waste services (4) in all
health care facilities (100% by 2030)
7. Increase of proportion of countries that have achieved their national targets on reducing HAIs (> 80% by 2030)
8. Increase of proportion of countries with a national HAI surveillance system (> 90% by 2030)
Four core targets at nationalb level
1. Increase of proportion of facilities meeting all WHO IPC Minimum Requirements for IPC programmes (> 90% by
2030)
2. Increase in the proportion of facilities with a dedicated and sufficient funding for WASH services and activities
(100% by 2030)
3. Increase of proportion of facilities providing training to all frontline clinical and cleaning staff upon employment
and annually and to managers upon employment (> 90% by 2030)
4. Increase of proportion of tertiary/secondary health care facilities having an HAI and related AMR surveillance
system (> 80% by 2030)
Abbreviations: HAI, health care-associated infections; IPC, infection prevention and control; MF, monitoring framework; TrACSS, Tracking
AMR Country Self- Assessment Survey.
ᵃ Reflecting progress at national level.
ᵇ Reflecting progress at facility level.
Source: (3).

Significant investments are required by all countries Available data show remarkable differences in IPC
to achieve these targets; therefore, resource capacity and progress between low- and lower-
mobilization is urgently needed for countries’ and middle-income countries and the other income
stakeholders’ support. However, compelling data levels (1). Therefore, the efforts to be made by these
demonstrate that a high return can derive from countries are greater and more urgent.
investments in IPC, both in terms of lives saved and
economic gains.

18
Action by WHO interventions using MMIS at the point of
care (15), IPC education and training, and
With its teams at the global, regional and country HAI surveillance.
levels, WHO is at the forefront to support all • Support also includes identification of
countries in this endeavor and based on country targets for action plan monitoring and for
gaps and demand, has prioritized capacity building HAI reduction, and data collection to feed
on IPC in 85 countries3 across all regions, with into the global monitoring framework for
special focus on countries with limited resources. IPC to demonstrate progress at the global,
national and facility level.
• In particular, WHO is committed to support
countries in the development of their Many country examples exist demonstrating
national action plan on IPC, based upon the excellence in advancing IPC programmes and
local situation analysis and in line with the interventions, and are described by WHO (1, 33,
WHO global action plan (3). 34). In particular, Box 5.1 illustrates successful
• WHO supports implementation of actions examples of practices improvement and HAI
related to capacity building in health reduction following the implementation of MMIS,
care facilities in priority areas, such that can inspire others to adopt and adapt these IPC
as implementation of IPC and WASH interventions.

Box 5.1. Country examples in implementing IPC interventions at the

point of care using MMIS

National IPC initiative on reducing CLABSI in Saudi Arabia: ICU staff in participating hospital in Riyadh, celebrates the successful
implementation of the initiative, after more than one year without CLABSI. © King Salman Hospital, Riyadh, Saudi Arabia.

MMIS (15) are the modern and smartest way to implement IPC interventions to achieve the system
change, climate and behaviour that support IPC progress and, ultimately, the measurable impact
that benefits patients and health workers. MMIS are usually utilized to improve specific practices
(for example hand hygiene) and often include bundles (for example a bundle of measures to reduce
infections associated with vascular catheters) and checklists. Several successful examples of
implementing MMIS in real life are available for example to improve hand hygiene practices (42), and
to reduce surgical site infections (43), CLABSI (16, 17), and hospital-acquired pneumonia (44, 45).

Abbreviations: CLABSI: central line-associated bloodstream infections; ICU: intensive care unit; IPC, infection
prevention and control; MMIS: multimodal improvement strategies.

3
Country distribution by region: African Region, 11 countries; Region of the Americas, 21 countries; South-east Asia Region, 11 countries;
Eastern Mediterranean Region, 12 countries; European Region, 22 countries; Western Pacific Region, 7 countries.

19
 Action by international/ • contribute to data collection on IPC and
HAIs and their use for action;
national stakeholders and • support research on IPC, including on low-

donors cost solutions.

Action and investment by international and non- Conclusions

governmental organizations, and donors as well as
by higher-income and more advanced countries in These efforts not only will benefit the people and
the field of IPC, can make a huge difference both health systems of all countries protecting them
at the global level and for countries and facilities, from avoidable infections but will also strongly
in particular where resources and expertise are contribute to the achievement of the health-related
limited. Sustainable Development Goals (46).

International/national stakeholders and donors can: They will also contribute towards the effective
implementation of other major global health
• provide strategic support for the priorities, including global health security and the
identification of country priorities for IPC International Health Regulations (IHR) (47), AMR
and WASH and the development of national action plans and targets (48), patient and health
action plans; worker safety (49, 50), and quality health services
• provide financial and technical support to delivery (51). Furthermore, the overarching focus
implement the IPC national action plans, on quality essential health services as part of a
with special attention to address real local primary health care-driven approach to universal
needs, and avoiding duplication of efforts; health coverage is well-served by having strong IPC
• maximize collaboration and coordination; implementation at all levels of the health service.

20
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