At the 77th World Health Assembly, our message for health leaders was clear: water, sanitation and hygiene must be at the heart of solutions and decisions to tackle global health threats, including antimicrobial resistance.
Antimicrobial resistance (AMR) is a global killer – and mothers and babies are easy targets.
But we cannot fight AMR without preventing infections in the first place.
And we cannot prevent these infections when 2.2 billion people around the world still don’t have safe water.
Clean water, decent sanitation and good hygiene are needed now to protect vulnerable people, such as mothers and their babies, and the healthcare workers who treat them.
Half of all healthcare facilities don’t have basic hygiene services.
Half of all healthcare facilities don’t have basic hygiene services.
Every two seconds, a woman gives birth in a health centre without adequate water, sanitation and hygiene
Every two seconds, a woman gives birth in a health centre without adequate water, sanitation and hygiene
in the world’s least developed countries.
A third of newborn deaths related to sepsis are linked to drug-resistant pathogens.
A third of newborn deaths related to sepsis are linked to drug-resistant pathogens.
A silent pandemic
Antibiotics play an essential role in treating people who develop infections and sepsis, which happens when the immune system overreacts to an infection and starts to damage the body's own tissues and organs.
However, antibiotics have been overused and misused as a quick fix in places without clean water and good hygiene. This has helped to create a deadly crisis – antimicrobial resistance.
Now, many healthcare staff are helpless in the face of infections, and mothers and their newborn babies are at high risk of drug-resistant infections and life-threatening sepsis.
Antimicrobial resistance occurs when germs, such as bacteria or fungi, are no longer affected by the drugs designed to kill them. This makes it difficult, and at times impossible, for doctors to prevent and control infections among patients.
Resistance to antibiotics is a large part of this problem, which is already a major cause of death worldwide, contributing to around five million deaths every year.
With clean water, decent toilets and good hygiene, we can save mothers and their babies, and protect people’s health worldwide.
Frequent handwashing by mothers and their healthcare workers, using clean equipment, and cleaning healthcare wards can all help to break the chain of infection, slow the spread of drug-resistant germs, and reduce the need for antibiotics.
In fact, AMR can be reduced by 85% through improved hand hygiene, along with stewardship programmes and better environmental hygiene in health centres.
“In the past two months, we have only had one case of sepsis that required the use of antibiotics. As someone working on the maternity ward, I see the change in how we administer antibiotics owing to the easy access to safe and clean water.”
– Zelifa Nzoma, 39, nurse and midwife technician at Nkhuzi Health Centre in Ntchisi, Malawi.
“The antibiotic use is lower now because our clinic is clean, so both mother and child leave without any infection ... I haven’t used antibiotics in months, because the environment is health friendly.”
– Joseph Siame, clinical officer at Busolwa Dispensary, Geita, Tanzania.
Water, sanitation and hygiene is what women want.
When asked about their top demands for maternal healthcare, 1.2 million women from 114 countries responded with a clear message: water, sanitation and hygiene (WASH) is the second highest priority (PDF), after respectful and dignified care.
Only when we take on board the knowledge and experiences of communities, and actively listen to those on the frontline of healthcare, will we be able to collectively fight global threats like AMR.
WaterAid at the World Health Assembly
At the 77th World Health Assembly, our international delegation spread a clear message:
Clean water, decent sanitation and good hygiene must be at the heart of solutions and decisions to tackle global health threats, including AMR, climate change and the prevention of future pandemics.
At the assembly, it was positive to see member states take steps in the right direction across these issues. Here is the key progress for WASH and what needs to happen next.
Tackling antimicrobial resistance
To help slow the spread of AMR, member states approved a new resolution to accelerate national and global AMR responses (PDF). This important step forward calls on countries to strengthen health systems by improving access to WASH in healthcare facilities, among other strategies.
To turn this ambition into reality, we call on leaders to:
- Include WASH in healthcare facilities and communities as a key AMR prevention strategy in the upcoming political declaration at the UN General Assembly (PDF)
- Increase investment in WASH in healthcare facilities and communities, in line with relevant AMR national action plans
Addressing climate change and health
Recognising the threat that climate change poses to people's health, the adoption of a new dedicated resolution on climate and health (PDF) won strong support from both member states and us here at WaterAid, following our calls for urgent investment in climate-resilient and sustainable healthcare systems.
We call on leaders to ensure that financing matches this ambition, in line with the resolution's acknowledgement that limited access to finance remains a major obstacle to building climate-resilient health systems. Crucially, we also call for adequate budgets for WASH, which is essential to achieving this goal.
Improving infection prevention and control
In a win for public health everywhere, member states approved the global action plan and monitoring framework on infection prevention and control (PDF). This framework includes clear targets for increasing access to WASH in healthcare facilities, targeting universal access by 2030.
To make sure actions match words, we will continue to call for increased financing for WASH in these settings so that healthcare workers have the essentials they need to do their jobs, and patients can access treatment without fear of acquiring an infection.
Accelerating maternal, newborn and child health
Global progress to reduce maternal, newborn and child mortality has drastically stalled, putting lives at risk and keeping the world off track from meeting the related Sustainable Development Goal targets.
Noting the urgent need to address this, member states approved a proposed resolution (PDF) that calls on countries to accelerate progress in tackling the leading causes of maternal and child deaths, especially in the worst-affected countries.
One of the major roadblocks is limited progress on a 2019 resolution (PDF) to ensure access to clean water, sanitation and hygiene in healthcare facilities. We call on leaders to urgently prioritise access to these essentials in every health centre, everywhere, to help reduce infections, improve quality of care, and achieve better health outcomes for childbearing women, newborns and children.
Fostering global collaboration for WASH
In an event for leaders, Malawi’s Minister of Health, Hon. Khumbize Kandodo Chiponda MP, hosted health ministers, high commissioners and government representatives from across the globe, in collaboration with our delegates and the World Health Organization.
Representatives from Gambia, Japan, Liberia, Sweden, Tanzania, Zambia and Zimbabwe shared their insights and commitments to accelerating priority actions for improving WASH, waste management, electricity, and infection prevention and control in healthcare facilities.
Discussions extended to bolstering climate resilience and improving service delivery in line with the Global Framework for Action 2024-2030 (PDF) and the Global Strategy on Infection Prevention and Control.
Prevention first
Our report sets out how these essential services can slow the rise of antibiotic resistance, and how the UK can lead efforts to tackle the rising threat of drug-resistant infections.
Counting the cost of infections
Our latest research shows that the lack of basic water and hygiene services in healthcare facilities not only increases the risk of infections but has severe economic consequences for low and middle-income countries.
Investment that saves lives
Our policy brief highlights the critical actions governments and donors must take to attain safe, dignified and quality care, and improve patient and health worker safety.
Hygiene for health
From advocating for water, sanitation and hygiene in health centres to developing national hand hygiene roadmaps, read about the highlights of our global health campaign.
Top image: Elisa Ravaoarisoa, 28, and her newborn baby at their home in Manjakandriana commune, Analamanga region, Madagascar. November 2020.