At 2021's World Health Assembly, we called on world leaders to keep their promises and ensure that urgent investment in hygiene and public health is central to responding to COVID-19 and rebuilding after the pandemic. 

The World Health Assembly is the annual gathering of health ministers to agree actions on urgent health issues. From 24 May to 1 June 2021, ministers will meet virtually to agree on actions on urgent health issues such as reviewing progress on the 2019 resolution on water, sanitation and hygiene (WASH) in healthcare facilities, responding to COVID-19, pandemic preparedness, and patient safety.

The COVID-19 pandemic, with all its destruction, represents an opportunity for the world to come together against a common enemy. We have all seen how devastation in one part of the world quickly impacts all of us; from the pain of losing loved ones and being separated from friends and family, to individual economic hardships and struggling livelihoods. But this crisis is not an equal one. It has exacerbated inequalities and left the most vulnerable in an even more precarious situation. 

While vaccinations against COVID-19 are a light at the end of this tunnel, they are not a silver bullet for fighting disease. The reemergence of Ebola in West Africa, and the threat of antibiotic-resistant ‘super-bugs’, too, show us that this pandemic will not be the last we face. Without ambitious action to strengthen public health and pandemic preparedness everywhere, we cannot protect ourselves or each other. 

Hygiene is a first line of defence against COVID-19 and other infectious diseases, for communities, health workers and their patients. It is a ‘best buy’ - fundamental for public health, quality healthcare and protection from future pandemics. Yet billions of people and health workers are unable to wash their hands with soap and clean water. Without hygiene, healthcare is unsafe, and lives are lost. This must change now. 

We are deeply concerned that, despite promising to do so, governments and donors have failed to prioritise clean water, soap and decent toilets for communities and frontline health workers as one of the pillars of COVID-19 response and pandemic preparedness. This has left our mothers, sisters, brothers and fathers working or being treated in healthcare facilities and other public places with no choice but to ration handwashing; the very shield they need to protect themselves and their patients. 

This goes against World Health Organization advice (PDF), huge public support in the world’s wealthiest countries, and the promises all health ministers made two years ago at the World Health Assembly, when they unanimously adopted the resolution on water, sanitation and hygiene in healthcare facilities (PDF). The trillions of dollars spent and global mobilisation achieved in response to COVID-19 show that action is possible when the world’s leaders decide to act. 

Yet globally: 

  • 3 billion people lack access to soap and water at home to wash their hands
  • 1.8 billion people are at higher risk of COVID-19 and other infectious diseases because they use or work in a healthcare facility which lacks basic water services
  • One in three healthcare facilities do not have readily available access to handwashing facilities 
  • Almost half of healthcare facilities in least developed countries lack basic water services 

The world was not ready for COVID-19. We must get the basics right so that we are prepared to face the next pandemic. 

We urge heads of government and health ministers to ensure that urgent investment in hygiene and public health is central to any strategy to respond to and rebuild after COVID-19, in line with WHO guidance, and in light of shrinking economies the world over, by taking the following critical actions.

  • End the COVID-19 pandemic by promoting equal access to vaccines as part of a wider commitment to equity and long-term pandemic preparedness, that also includes strengthening health systems and improving quality of care through WASH. Capitalise on the roll-out of COVID-19 vaccines by integrating nationwide hygiene promotion, thereby strengthening community resilience to future outbreaks.
  • Build resilience of the most vulnerable health workers and patients by rapidly implementing the commitments outlined in the WHA72 resolution on WASH in healthcare facilities. Invest in services, infrastructure, supplies and training for all frontline health workers – 70% of whom are women – including cleaners and auxiliary staff. 

Watch our short animation on the importance of WASH in healthcare facilities.

Everyone, everywhere

Achieving universal health coverage through water, sanitation and hygiene

WaterAid/Carielle Doe

Top image: Patricia Mwenyeheri, nurse and midwife technician, washes her hands after attending to a patient, Mzandu Health Centre, Ntchisi, Malawi, July 2019.