On 22 March 2018, UN Secretary General Antonio Guterres launched a Call to Action which envisions universal and sustainable access to safe drinking water, sanitation and hygiene (WASH) in all health care facilities (HCF). The Call to Action particularly focuses on low- and middle-income countries where basic services are frequently lacking.
WHO and UNICEF are developing a global response to the Call to Action on WASH in HCF. This work will build upon global WASH in HCF efforts which were undertaken following the release of the WHO/UNICEF 2015 landscape synthesis report. The response includes a vision, measurable targets and an associated set of metrics for progress. These metrics are based on a priori knowledge of efforts and are balance being aspirational and realistic.
Achieving health for all, and in particular universal health coverage (UHC), depends on the availability of, at minimum, basic WASH services in all health care facilities. Without WASH, it is impossible to provide quality care, prevent health care-associated infections (HAI) and reduce the spread of antimicrobial resistance (AMR). WASH provides the enabling environment for health care workers to perform care using infection prevention and control (IPC) best practices and keep patients, staff and care givers safe. It is also important for accelerating health security and when implemented with green energy solutions, for strengthening climate resilience. Finally, WASH is fundamental for respecting the dignity and human rights of all care seekers, especially mothers, newborns and children as well as health care staff.
Initial global efforts helped raise awareness, develop tools and resources, and embed WASH in global health standards and frameworks. Multiple countries (more than fifteen across five regions) are now engaged in WASH FIT implementation and supporting infrastructure improvements for WASH in HCF. Regional and multilateral instruments, such as the European Protocol on Water and Health, have been adopted and actively promote WASH in HCF. The Joint Monitoring Programme (JMP) has initiated synthesis of data from more than fifty countries and a global report is being prepared, to be released at the end of 2018. Furthermore in the 2018 round of data collection for the UN-Water Global Analysis and Assessment of Sanitation and Drinking-water (GLAAS), information is being collected on financing and investments into water and sanitation, including in health care facilities. Simultaneous efforts on strengthening quality of care (especially for mothers, newborns and children), IPC and AMR guidance has built the momentum of greater recognition from countries and partners to address the current gaps in WASH in HCF. The concerns for global health security, including recent Ebola outbreaks in the Democratic Republic of Congo amplify the need for immediate action to improve the current hazardous state of WASH in HCF.