Prevention first: why clean water and hygiene are the best medicine against the spread of drug-resistant infections

Deadly infections can spread rapidly in hospitals without clean water, decent sanitation and good hygiene. And yet half of all healthcare facilities don’t have a place for staff or patients to wash their hands. A new 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.

Antibiotic resistance is a growing global health emergency, contributing to nearly five million deaths every year.

When hospitals and clinics are unclean and don’t have adequate water, sanitation and hygiene (WASH) services, infectious diseases can spread rapidly, leaving healthcare workers in some countries with no choice but to over-prescribe antibiotics. This presents a serious concern for global public health when one in two healthcare facilities do not have basic hand hygiene services.

This new report shows how investing in adequate WASH services in healthcare facilities reduces the demand for antibiotics, breaks the chain of infection and lowers the opportunity for resistant infections to become dominant.

The report was written by the UK’s All-Party Parliamentary Groups (APPG) on Antibiotics, and on Water, Sanitation and Hygiene, and facilitated by the British Society for Antimicrobial Chemotherapy and WaterAid. The APPGs staged a joint inquiry into the links between antibiotic resistance and a lack of access to WASH facilities in healthcare settings in the world’s least-developed countries. The report captures the written and oral evidence from experts on these issues and underlines the urgent need to close the funding gap for WASH in healthcare facilities to slow the spread of drug-resistant infections.

The report highlights that investment in WASH in healthcare facilities:

• is an immediate, affordable high-impact option for tackling antibiotic resistance in low-income countries and will provide a rapid return on investment.
• has the potential to help save lives from day one, and to continue delivering returns for decades to come.
• will buy time to develop new drugs and other approaches to tackle antibiotic resistance.

The report also includes key recommendations for the UK government to take the lead on international advocacy for WASH in healthcare facilities to help prevent antibiotic resistance.