Good hand hygiene is essential to fighting antibiotic resistance and infection prevention and control in health facilities. In the lead up to the World Health Organization’s Save Lives: Clean your hands campaign on 5 May, WaterAid is calling for better access to clean water, decent toilets and good hygiene in health facilities in developing countries. Without optimal infection prevention practices, germs, including those resistant to antibiotics, spread. Antimicrobial resistance presents a significant threat to human health. Improving infection prevention and control, and water, sanitation and hygiene in health facilities is essential to address this. The Australian Government has pledged $100 million over five years to address antimicrobial resistance and other global health challenges in the Asia Pacific region through a regional health security initiative. Details of the initiative have not yet been released. “Good hand hygiene in health facilities in the Asia Pacific region is central to ensuring health security in Australia and the region, protecting the region from large scale infectious outbreaks and antibiotic resistance. Infections know no borders,” said Rosie Wheen, WaterAid Australia Chief Executive. “WaterAid eagerly awaits the Australian Government’s health security initiative and urges that access to clean water, decent toilets and good hygiene in health care facilities in the region is prioritised as it is an essential part in preventing antibiotic resistance and protecting people from life-threatening infections,” said Ms Wheen. Currently in health care facilities in low and middle income countries: 38% of health care facilities do not have any water source 19% do not have improved toilets 35% do not have water and soap or alcohol-based hand rub for hand washing About 700,000 people die each year from resistant infection; this is predicted to rise to 10 million by 2050 if action isn’t taken to address antimicrobial resistance Health care associated infections are thought to be the third major driver for antimicrobial resistance Compliance for recommended hand hygiene practices on average are only 40% among health care workers Hospital-born babies in low-income settings are at a higher risk of being affected by neonatal sepsis, with infection rates 3 to 20 times higher than in high-income settings On average 15% of patients will acquire at least one infection in acute care hospitals Each year hundreds of millions of cases of diarrhoea are treated with antibiotics. Universal access to clean water, sanitation and hygiene could reduce this by 60% “Lack of water, sanitation and hygiene in health care facilities and compromised infection prevention and control practices can lead to: the increased risk and spread of health care-associated infections; the increased burden of expensive, hard-to-treat and life-threatening resistant infections; and a decrease in patient confidence in health care. In turn this leads to overreliance on preventive use of antibiotics, high health care costs and poor health outcomes, increased use of antibiotics to treat preventable infections and increased resistance,” said Ms Wheen. It is imperative that health facilities have safely managed water, sanitation, hygiene and waste management facilities and implement effective, evidence-based infection prevention and control programs and practices to protect the lives of health workers, patients and surrounding communities. “It is important for health workers to be able to clean their hands at the right times, for organisations to support hand hygiene campaigning and infection prevention and control programs to protect patients and staff from antibiotic-resistant infections and for policy makers to stop antimicrobial resistance by demonstrating national support and commitment to infection prevention and water, toilets, waste management and hygiene” said Ms Wheen. WaterAid is committed to improving hygiene, water, toilets and waste systems in health facilities to ensure everyone, everywhere can enjoy dignified and quality health care services that improve their lives. We are creating partnerships with ministries of health, medical professionals and health organisations to help fulfil this ambition.