Kristina E. RuddNiranjan KissoonDIrek LimmathurotsakulSotharith BoryBirungi MutahungaChristopher W. SeymourDerek C. AngusT. Eoin WestUniversity of Washington, SeattleMahidol UniversityUniversity of Pittsburgh Medical CenterThe University of British ColumbiaNuffield Department of Clinical MedicineUniversity of Pittsburgh School of MedicineBwindi Community HospitalCalmette Hospital2019-08-232019-08-232018-09-23Critical Care. Vol.22, No.1 (2018), 1233050591466609X136485352-s2.0-85053724139https://repository.li.mahidol.ac.th/handle/20.500.14594/46317© 2018 The Author(s). Sepsis is a major contributor to the global burden of disease. The majority of sepsis cases and deaths are estimated to occur in low and middle-income countries. Barriers to reducing the global burden of sepsis include difficulty quantifying attributable morbidity and mortality, low awareness, poverty and health inequity, and under-resourced and low-resilience public health and acute health care delivery systems. Important differences in the populations at risk, infecting pathogens, and clinical capacity to manage sepsis in high and low-resource settings necessitate context-specific approaches to this significant problem. We review these challenges and propose strategies to overcome them. These strategies include strengthening health systems, accurately identifying and quantifying sepsis cases, conducting inclusive research, establishing data-driven and context-specific management guidelines, promoting creative clinical interventions, and advocacy.Mahidol UniversityMedicineReviewSCOPUS10.1186/s13054-018-2157-z