How we influenced change at the 2018 World Health Assembly 

May’s World Health Assembly featured important successes for global health and for WaterAid’s advocacy. Helen Hamilton, Senior Policy Analyst for Health and Hygiene at WaterAid UK, gives a window into how we helped drive progress and what this means for health and water, sanitation and hygiene.

In May a global delegation of WaterAid staff from Australia, Cambodia, Ghana, Malawi and the UK joined the World Health Assembly in May to make sure change happened. We had two priorities that we wanted to influence health ministers on:

• Support Zambia to lead a resolution calling for a greater multi-sectoral response to cholera and a stronger focus on prevention through WASH.

• Position water, sanitation and hygiene (WASH) as central to achieving universal health coverage (UHC).

Achieving high-level policy change: a new WHA resolution on cholera

Working with partners such as WHO and members of the Global Taskforce on Cholera Control, we set out to elevate the profile of cholera at WHA and generate increased global political commitment and resources for long-term cholera control through a cholera resolution. 

In the build up we had worked with WaterAid country programmes, WHO experts and cholera and WASH partners to secure support from member states, such as Zambia.

We took a two-pronged advocacy approach. Our global policy team met permanent missions in Geneva to discuss the importance of the cholera resolution and how they could support it. At the same time WaterAid country offices led targeted national advocacy to ministries of health, including holding meetings and writing letters to key health influencers.

Our strategy worked: Zambia put forward the resolution to other member states. A cholera-affected country, Zambia has been facing regular outbreaks for 35 years, so shifting towards long-term prevention of cholera was a priority we shared. We were delighted to see the Assembly pass the resolution under agenda item 'Public Health Preparedness and Response'.

Through this, member states showed their unanimous agreement both that cholera needs to be recognised as an increasing public health threat for many countries and regions, and that its unwelcome spread due to climate change is on the rise. Through the resolution, they expressed the urgent need for effective public health interventions, improved environmental management – in particular access to clean water and decent sanitation – and the adequate use of cholera vaccines as a complementary measure.

Countries signing the resolution emphasised that cholera prevention requires access to safe water and adequate sanitation, appropriate food safety, effective hygiene and a community-based approach.

Sharing what we know works from the frontline of the WASH crisis.

Speaking at events enabled us to raise the profile of important issues at the Assembly.

At an event on women's health and hygiene in the Sustainable Development Goal era, Channa Sam Ol, WASH and Health Program Manager from WaterAid Cambodia, spoke about how women’s leadership can help drive improved WASH in healthcare facilities and user-friendly services, and about the need to keep women, girls and children central when tackling health and hygiene. Channa shared her experience of promoting WASH through people-centred approaches and of strengthening female leadership in Cambodia by increasing women’s capacity and improving their facilities.

Annie Msosa, Head of Programmes for WaterAid Malawi, presented at our event 'Seizing the opportunity: catalysing quality UHC through water, sanitation and hygiene and infection prevention and control'. The event brought together senior leaders from the Ministries of Health in Mauritania and Liberia; WHO teams working on WASH, patient safety and antimicrobial resistance; and frontline experts including WaterAid. Annie shared our experience of working on WASH in healthcare facilities through the Deliver Life programme in Malawi. The event both reaffirmed collective support for WASH in healthcare facilities and won some new supporters for the issue.

Being heard in official proceedings: making statements

Making statements during the official committee session is our opportunity to share with member states and WHA delegates what we've learned from our programmes, and to represent the vulnerable communities we serve and our country programme teams' work. It is also a chance to raise WaterAid’s profile as a leading player in WASH and health.

Reinforced relationships with WHO teams

WHA is a great opportunity to meet with WHO staff in person both to discuss existing work and to meet new contacts.

We work especially closely with the WHO WASH team, but have built up relationships with teams across WHO. During the WHA week we met with teams for nutrition, cholera, antimicrobial resistance and maternal, child and adolescent health.

It's vital that we make these connections and engage with teams beyond the traditional WASH stakeholders – collaboration across sectors is key to us all achieving our goals. It's through these meetings that we can share lessons from our programmes and agree areas for collaboration, such as the roll-out of new programmes or contributing case studies and evidence from our work to WHO reports.

A resolution next year on WASH in healthcare facilities…

Building on the momentum of the cholera resolution, we have started work towards a formal resolution on the pivotal issue of WASH in healthcare facilities for 2019.

The first step was working with the Governments of Zambia and Tanzania, who put forward a draft resolution on WASH in healthcare facilities for next year's WHA. This is the beginning of a year-long process to secure member state support for this resolution, which could really help to drive global and national commitments, investment and action on improving WASH in healthcare facilities. 

This would be the first ever standalone resolution on this area – so it's an ambitious goal, but one we're excited about. The global advocacy team will be working closely with WaterAid country programmes and their networks to build support for the resolution from their governments. 

…and on to universal health coverage

The global push for UHC is for everyone, everywhere to have access to the healthcare they need, when they need it, in a way that doesn’t cause financial hardship. This is unachievable without access to safe, dignified WASH services in healthcare facilities. 
  
As Dr Maria Neira, WHO Director, Public Health, Environmental and Social Determinants of Health, said at one of our events "A healthcare facility without water, sanitation and hygiene is not a healthcare facility". This is at the core of what we’re fighting for. 

We know that water, sanitation and hygiene are not 'nice to haves' or 'add-ons' to the core business of health – they are fundamental to ensuring everyone has safe, quality healthcare. This is what the WASH in healthcare facilities resolution and our health influencing work will be driving towards during the next 12 months.