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Water, sanitation and hygiene are the essential first barrier to the transmission of superbugs, yet some 38% of healthcare facilities in low- and middle-income countries, and 42% in Sub-Saharan Africa, do not have access to water, making good hygiene and infection control and prevention almost impossible.
Anti-microbial resistance is exacerbated by widespread use and misuse of antibiotics. In places where hospital patients frequently contract infections because of poor sanitation and hygiene practices, they are often given antibiotics for prevention. The Review on Antimicrobial Resistance earlier this year warned that up to 10 million people may die every year from resistant infections by 2050. A World Bank report warned the impact on the world economy could be equivalent to the 2008 financial crisis, and could plunge 28 million people into poverty by 2050.
WaterAid Director of Global Policy and Campaigns Margaret Batty said:
“Preventing infection is the best way of saving lives. We cannot hope to slow the terrible march of anti-microbial resistance as long as antibiotics are being used to do the job of simple soap and water. Yet this is too often the case, as 38% of healthcare facilities in low- and middle-income countries do not even have access to water, making effective infection prevention and control nearly impossible. “The best way to prevent infection is to ensure that healthcare centres have continuous access to clean water, to good functioning sanitation, and to ensure medical personnel, from clinic directors to cleaners, have both the knowledge and ability to practice proper handwashing with soap.” “WaterAid has joined other non-governmental organisations and agencies in promising to promote the prevention of infection alongside sensible use of antibiotics. No plan to tackle this threat is complete without a strong focus on effective infection prevention and control, for which water, sanitation and hygiene are essential.”
WaterAid has led other NGOs in pledging to champion the delivery of quality healthcare including water, sanitation and hygiene as essential to the fight against anti-microbial resistance, alongside appropriate and sensible use of antibiotics. High rates of infection and sepsis are deadly to new mothers and newborns. One in five newborn deaths is from infection, such as sepsis, which can often be prevented with good hygiene and clean water. The 2015 World Health Organization landscape survey of healthcare facilities in low- and middle-income countries also found that 35% don’t have handwashing facilities and 19% don’t have any functioning toilets. Many facilities with some access to water also face issues of quality and disruptions in supply.
WaterAid’s four-year campaign Healthy Start is designed to highlight the critical importance of these basic services for maternal, newborn and child health. A WHO-Unicef Global Action Plan aims to address this situation; however to achieve access to water, sanitation and good hygiene in all healthcare facilities, it will need to be made a political priority by national governments and donors.