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He has even donated 60-to-70% of his yearly physician’s income to a foundation he created – the Foundation To Fight Against Nosocomial Infections – in order to raise awareness and money for this laudable cause. At first, Rosenthal’s concerns had fallen on deaf ears. “Back then, in developing countries, HAI was not part of the agenda,” Rosenthal said in his interview with The Suit. “As infection doctors in Argentina, we worked as consultants, going from hospital to hospital. At my hospital, patients were dramatically dying from HAI at an extremely high rate,” he asserted. “I discovered lack of infection-control practices, and I changed the process and reduced the incidence of HAI and mortality.”
He then made the decision to find a systematic and standardized solution to the HAI problem in all developing countries of the world. He analyzed extensive the data he collected on HAI rates and infection-control practices. Simple practices, he realized, such as cleanliness protocols, needed to be structured, and compliance with these practices needed to be monitored.
In 2002, he formed the International Nosocomial Infection Control Consortium (INICC), a non-profit international research networkto enlist hospitals and countries in the campaign. “Now, because infection control is a global problem, everyone is extremely hungry to learn about INICC,” he said, though it’s been a long road, he added.
Rosenthal earned his medical degree at the University of Buenos Aires in 1988, and then completed fellowship programs in Internal Medicine and Infectious Diseases from 1989 to 1992. Since 1989, he’s worked in hospitals, in which setting the suffering of patients and their families due to the fearful consequences of HAI had a powerful impact on him.
“I was struck by the fact [of finding] that HAI infection rates in Argentina are five times the standard for American hospitals. So I decided to shift from the area of infectious disease diagnosis and treatment to the area of infection control and prevention.”
Since 1993, Dr. Rosenthal has worked with a group of physicians editing the National Infection Control Guidelines at the Infectious Diseases Society of Argentina. They developed guidelines to reduce HAI, but the guidelines were not implemented. “Regulations on their own do not bring about changes in healthcare workers’ behavior,” he realized. 
Immediately, he began to conduct surveillance of device-associated infections at hospitals in Buenos Aires; those infections included central line-associated bloodstream infections, ventilator-associated pneumonia, catheter-associated urinary tract infections, and surgical site infections.
By 1998, he had helped create an innovative system. “There are two components,” he said animatedly. “One is Outcome Surveillance, to measure rates of HAI; the other is Process Surveillance, to measure compliance with Infection Control Guidelines by health-care workers.”
Rosenthal developed the guidelines, forms, manuals and training programs as well as database and statistical software in order to facilitate the analysis of these data. 
By 1999, he had clinical proof that the implementation of his Outcome and Process Surveillance system had produced significant improvement in patient safety, ultimately reducing costs. Within a year, three hospitals had implemented the system, with supportive results that were published in peer-reviewed journals and presented at international scientific meetings. 
He underwent further training, graduating from a program in Clinical Effectiveness sponsored jointly by HarvardUniversity and the University of Buenos Aires in 1999-2000. Then Rosenthal had a further inspiration.
“Hospital Administrators want to save money,” he said, and went to
work developing tools by which to measure the cost-effectiveness of infection control. Two years later, Rosenthal began receiving invitations to present his model of measurements in Colombia, Mexico, Brazil, Peru, Turkey and India.
“In all of these countries, healthcare workers showed a willingness and eagerness to be trained in my methodology,” he said. The Health Department of Bogota, Colombia, and the Undersecretary for Innovation and Quality in Mexico have also requested his assistance and counseling.
This was the beginning of INICC. In the ensuing years, theorganization’s training and research activities began making waves around the world, with hospitals from Brazil, Colombia, Peru, India and Morocco joining the INICC. By 2005, the organization further enhanced its international status with the creation of an International Advisory Board.
In 2006, the INICC published its first multi-centric study in the peer reviewed journal, Annals of Internal Medicine. That exposure made INICC’s system a world standard for measuring healthcare-associated infection rates in developing countries. By then, the breadth and diversity of participating countries had proven no less than remarkable as INICC members now included Croatia, the Philippines, Pakistan, Kosovo and Macedonia.
In 2007, Rosenthal created the Foundation to Fight Against Nosocomial Infections (FLIN) in order to garner wider support for low-resource healthcare facilities worldwide.“FLIN was set up to enhance INICC’s scientific activities by raising funds,” he said.
Currently, Uruguay, El Salvador, Costa Rica, Lebanon, Nigeria, Cuba, China, Panama, Tunisia, Venezuela, Greece, Lithuania and Vietnam have also joined the fight against HAI as members of INICC. As of last year, hospitals of 39 countries worldwide have joined – 15 from Latin America (Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, El Salvador, Guatemala, México, Panamá, Peru, Puerto Rico, Venezuela, Uruguay); 13 from Asia (China, India, Jordan, Lebanon, Malaysia, Pakistan, Philippines, Saudi Arabia, Singapore, Sri Lanka, Taiwan, Thailand, Vietnam); 10 from Europe (Bulgaria, Check republic, Greece, Kosovo, Lithuania, Macedonia, Poland, Romania, Turkey, Ukraine); and 5 from Africa (Egypt, Morocco, Nigeria, Sudan, Tunisia). In effect, the programs developed by Rosenthal and the INICC have grown popular directly because they work. Unfortunately, however, Rosenthal admitted, “We have a lack of dollars, and therefore a lack of professionals to [send out to hospitals] to institute surveillance methods and train people.” 
In the December 2010 issue of SHEA’s (Society For Health Care Epidemiology of America) official peer review journal, indexed in pubmed as, “Infection control and hospital epidemiology,” INICC posits how it is possible to significantly reduce the HAI rates by 54% and mortality rates by 58% in 15 developing countries. INICC now looks to apply this strategy in all 144 developing countries worldwide, and not just in those 15 countries.
Dr. Victor Rosenthal is working aroundtheclock to see his vision of lowered HAI and HAI-related mortality rates a reality. Constantly speaking at international scientific conferences around the globe and utilizing the INICC network, he continues to advocate for patient safety.
The HAI crisis threatens hospitalized patients, more so in developing countries, and it can be fought by applying infection control guidelines, by monitoring practices and procedures, and by providing performance feedback to healthcare workers. The INICC offers an effective and feasible model for the developing world, but what hampers its work is lack of funding, which factor remains a hindrance so long as it depends mostly on people like Rosenthal, who, as a major donor to FLIN, donates 60-to-70% of his personal income. He needs help to fund his work, and he hopes that more people around the world will donate to the cause and help make his dream of patient safety a reality.

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