Everyone, everywhere has the right to clean water and soap to wash their hands. We call on health and finance ministers to invest in water, sanitation and hygiene to improve health, safeguard against infectious diseases, and protect communities from future health crises. 

We have all seen how healthcare systems and economies around the world have struggled to cope in the face of COVID-19. In the poorest countries, the pandemic has highlighted the alarming state of healthcare facilities, including major gaps in the availability of water, sanitation and hygiene services. These are the most basic requirements for providing safe, quality and dignified healthcare, which everyone deserves.

Healthcare facilities and communities need access to water, sanitation and hygiene to keep people safe: to prevent and control infections, to protect mothers and babies during childbirth, to curb the rise of antimicrobial resistance, and to protect us all from future health crises.

Despite all the suffering caused by COVID-19, and the threat of emerging and future health crises, governments are yet to invest properly in water, sanitation and hygiene in healthcare facilities and communities. Investments could ensure resilient health systems and healthy populations, unlock trillions of dollars in economic benefits, and help lift millions out of poverty.

Instead, almost 2 billion people – one in four – are at risk of contracting infectious diseases simply because they don’t have handwashing facilities at home, and 1.7 billion people – more than one in five – risk illness because they use or work in a healthcare facility without basic water services. 

We are not in this situation because we lack the knowledge or resources to make the changes needed. It is because political decisions have caused health systems in the world’s poorest countries to prioritise cures over prevention. This approach keeps healthcare costs high, while making inequalities worse.

COVID-19 is a crisis of fundamentals. The pandemic has taught us that governments cannot afford to ignore the very basics of healthcare if they want to maintain a healthy economy. It is time for governments to take some bold steps: to build health systems that protect people and their economies from health emergencies, by making healthcare safe and preventing disease in the first place.

It will cost at least $11 billion between now and 2030 to deliver hand hygiene in every home, and $8.1 billion to have water, sanitation and hygiene in every healthcare facility in the poorest countries. This is a crucial and smart investment that could strengthen our collective defences against future pandemics.

With good hygiene, healthcare is safe, lives are saved, economies thrive and people prosper.

Almost 2 billion people don't have soap and water to wash their hands at home.

Half of all healthcare facilities lack a basic hygiene service.

One in ten healthcare facilities have poor toilets or no toilets at all.

Our impact

  • 25 January 2021: The EU Delegation in Malawi commits US$69 million to Malawi’s COVID-19 response, including funding for water, sanitation and hygiene, and mitigating pandemics.

  • February 2021: The Southern Africa Development Community (SADC) secretariat endorses the SADC Community Hygiene Strategy and begins work towards its adoption by the Council of Ministers. The strategy aims to enable member states to significantly increase hygiene access and behaviour change in homes, schools, healthcare facilities and public places to improve the quality of life for people in the region.

  • March 2021: The First Lady of Malawi, Her Excellency Monica Chakwera, commits to championing WASH in healthcare facilities and lobbying for increased financing.

  • April 2021: The Ministry of Health in Nepal integrates hygiene behaviour change promotion into its COVID-19 vaccination roll-out and other routine immunisation programmes in more than 16,000 health clinics.

  • 21 May 2021: At the G20 Global Health Summit, specific mentions of water, sanitation and hygiene are made in the resulting 2021 Rome Declaration.

  • 4 June 2021: A communique from the G7 health ministers meeting recognises the role of water, sanitation and hygiene in the fight against COVID-19, and in advancing broader global health security and the strengthening of health systems.

  • 23 June 2021: An EU Parliament report on the role of the EU in addressing COVID-19 specifically calls for more funding for universal basic services, notably health, water and sanitation services.

  • August 2021: Malawi's Minister of Health, Khumbize Kandodo Chimponda, commits to championing a resolution on WASH in healthcare facilities at the World Health Assembly in 2022.

  • July 2021: A US Congress report recommends that $475 million be spent on "long-term, sustainable water supply, sanitation and hygiene products" noting that they are "a critical component of disease prevention". The report also recommends that sanitary and hygiene products are included in specifications for personal protective equipment, and in the design and implementation of USAID’s provisions for frontline workers.

  • October 2021: The government of Ethiopia develops a costed roadmap for hand hygiene for all – a budgeted plan to ensure everyone in the country has access to handwashing facilities.

  • October 2021: A US Senate bill includes $500 million for water supply, sanitation and hygiene, of which $250 million is dedicated to programmes in sub-Saharan Africa.

  • November 2021: Health ministers of the Southern Africa Development Community endorse the SADC Hygiene Strategy.

  • November 2021: Resolutions from the joint Africa Water Week and AfricaSan talks includes specific calls to governments in Africa to prioritise, increase financing and strengthen data and accountability for hygiene.

Top image: Hospital cleaner Sor Socheat, 35, in the delivery room of Battambang Referral Hospital, Sampov Loun Hospital, Cambodia. February 2017.