At 2022's World Health Assembly, we called on world leaders to ensure urgent action and investment in water, sanitation and hygiene (WASH) as fundamental components of public health, quality healthcare and the prevention, preparedness and response to future health threats and pandemics.

Between 22 and 28 May 2022, ministers of health convened in Geneva, Switzerland for the annual meeting to agree priority actions for global health for the year ahead. This year's World Health Assembly (WHA) was held under the theme “Health for peace: peace for health”, with a focus on strengthening preparedness for and response to health emergencies.

The COVID-19 pandemic – along with other recent and ongoing health emergencies including Ebola and cholera and the growing threat of antibiotic-resistant ‘super-bugs’ – has highlighted the vital importance of hygiene, alongside water and sanitation, in preventing and controlling outbreaks, and its vital role in the delivery of safe, quality healthcare.

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

  • 2.3 billion people lack access to soap and water at home to wash their hands
  • 1.8 billion people are at higher risk of contracting infectious diseases such as COVID-19 because they use or work in a healthcare facility that 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. 

As governments deliberate and negotiate new frameworks and approaches to strengthening WHO’s work in health emergencies and pandemic prevention, preparedness and response, we fear that basic and essential public health measures, including WASH, will be forgotten or neglected. Dr Tedros Adhanom Ghebreyesus himself spoke in his opening remarks of the importance of addressing the root causes of ill health, noting that globally only 3% of health budgets is spent on promotion and prevention. He further committed to supporting member states to focus on high-impact transformations, one of which is ensuring every healthcare facility has access to water and sanitation. 

Our focus at the 2022 Assembly was therefore to continue to raise the profile and importance of WASH in these discussions, to ensure its adequate inclusion. We made a statement on the proposed resolution on infection prevention and control, highlighting the vital role of WASH in preventing patients from catching infections while receiving healthcare. We welcomed the adoption of the resolution, which calls for WASH infrastructure and resources to be made available in all healthcare facilities, and includes explicit recognition of the importance of hand hygiene.

The Assembly also raised critical issues related to member states’ sustainable financing of WHO as the lead agency coordinating global health and health emergencies. It made a landmark decision to gradually increase member states’ assessed contributions from 16% to 50% of WHO’s base budget by the 2030–31 budget cycle. This will enable a more flexible, better coordinated and more efficient WHO, at the centre of strengthened global health governance architecture.

At the same time, continued shrinking of civil society space in global health governance is deeply concerning. This year a last-minute decision by WHO to limit the size of civil society delegations and remove online delegations meant marginalised groups couldn’t have their voices heard. We continue to call for civil society spaces everywhere to be protected in key health discussions, and made a formal statement to the WHA on this, highlighting civil society’s transformative role in meeting global health opportunities and challenges, including improving access to WASH in healthcare facilities.

We also held a Twitter Space with civil society organisations and activists from around the world to discuss the challenge shrinking civil society participation poses, and practical actions to address it and ensure better inclusion in key WHO governance processes such as the WHA and development of the International Treaty on Pandemic Preparedness. We will soon release a podcast capturing this space.

Health ministers, WHO and partners must:

  • Champion integration of WASH into plans and frameworks to strengthen pandemic prevention, preparedness and response, including in the new international treaty on pandemic preparedness, in recognition that WASH is fundamental to an effective ‘one health’ approach.
  • Integrate WASH in efforts to strengthen infection prevention and control, including its adequate monitoring, resourcing and coordination for resilient health systems and stronger preparation for the next pandemic.
  • Commit to including and investing in WASH in healthcare facilities and hand hygiene for all as core components of national pandemic preparedness plans, to help their populations and economies recover from the current pandemic and prepare better for future health emergencies.
  • 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.