The scandal of 3 billion people abandoned to face pandemic with nowhere to wash their hands

Posted by
Emily Pritchard
12 May 2020
WaterAid/ De Sharbendu

The poorest people in the world are being left to face the COVID-19 pandemic alone with not even the most basic defence - clean water and a bar of soap. A shocking three billion people have nowhere to wash their hands with soap and water at home, despite this being one of the only ways to prevent the spread of the deadly disease.  

Health centres risk becoming the epicentres of the disease putting the lives of doctors, nurses and midwives at risk to save others. Two in five healthcare centres globally do not have anywhere for them to wash their hands with soap and water where they treat patients. 
Ahead of the most important global health meeting of a generation, WaterAid is urging health ministers to protect the lives of their people and healthcare workers and get soap and clean water to everyone to help keep them safe.  
There are currently no approved treatments or vaccines for COVID-19 and everyone is reliant on good hygiene and infection prevention and control to stop the spread. Whilst vaccines and therapeutics are urgently needed, lives are being put at risk every day because the very basics of disease prevention are being ignored. Last year, the world’s health ministers committed to ensuring clean water was available in every hospital and health care centre but there has been woefully little progress. 
Despite the dire statistics, the importance of access to hygiene and clean water has been worryingly overlooked by world leaders in the current crisis. Governments have been quick to promote hand hygiene and handwashing, but without acknowledging that this is shockingly still impossible for the three billion people around the world who lack clean water and soap in their homes, and for millions of frontline health workers and their patients in clinics and hospitals.   
The draft World Health Assembly (WHA) resolution on COVID-19, which will be discussed at a virtual WHA next week, has no mention of water and hygiene access as fundamental preventative and protective measures, and fails to put in a place any sort of plan to tackle the huge gaps in access to this first line of defence. WaterAid believes this is a dereliction of duty from both donor countries and national governments of countries where access is low, and flies in the face of WHO’s advice to Member States which calls for urgent provision of hygiene services in communities and health centres. 

This follows similar exclusions of water and hygiene from almost all of the COVID-19 emergency funding released by Governments and donor agencies over the past two months. Of 51 major announcements of financial support from donor agencies to developing countries only six have included any mention of hygiene*.  

Patricia Mwenyeheri is a nurse and midwife at Mzandu Health Centre in Ntchisi, Malawi. She considers herself lucky, in that she works in a health care centre where they have two handbasins with soap, but she is worried about what will happen if COVID-19 comes to the centre.

Patricia Mwenyeheri, nurse and midwife technician, washing her hands after attending to a patient, Mzandu Health Centre, Ntchisi, Malawi, July 2019.
WaterAid/ Dennis Lupenga

Patricia said: “Once we have even one case of COVID-19, it can quickly spread in our hospital, because we do not have the necessary resources. It makes me worried every day, I have seen other health workers are losing their lives whilst treating clients who have coronavirus. It makes me scared.”  
Cases in Africa were trailing far behind the hotspots in the USA and Europe, but cases are now rising in nearly all countries on the continent, even as they begin to fall elsewhere. There have been more than 63,000 reported cases and over 2,000 deaths, and WHO has raised alarm that the African continent may see as many as 190,000 deaths in the first year of COVID-19.  Every country in the world is vulnerable whilst the virus is still spreading.   
Tim Wainwright, CEO, WaterAid, said:

“We’ve rightfully seen huge investment in a search for COVID-19 vaccines and treatments, but this has failed to go hand in hand with any real commitment to prevention. You cannot preach handwashing but ignore the billions of people who don’t have soap and water.   
“Leaders are being willingly complacent in addressing a decades-old crisis that is driven by deeply entrenched inequality but now threatens the health of everyone. No one country can claim to have beaten COVID-19 whilst poor hygiene and weak health systems allow it to run rampant through other parts of the world. This is a threat to all of us and it’s time that our response included proper commitments to prevention as well as to cures.”   
Professor Wendy Graham from London School of Hygiene & Tropical Medicine (LSHTM), said:

“A year ago, the World Health Assembly Resolution on water, toilets and hygiene in healthcare facilities offered such promise to tackle the obstacles to providing clean, safe care. Dr Tedros himself held up a mop to reinforce the clear commitments that were made to ensure all facilities have reliable water supplies to enable cleaning both of hands and of the care environment. Sadly, too little progress has been made in meeting those commitments. COVID-19 is a stark reminder that we ignore these basics of hygiene at the peril of humanity.”   

For more information please contact
Emily Pritchard, Global News Manager, [email protected]
or call 07725 991201
Fiona Callister, Global Head of Media, [email protected]  
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Notes to Editors  
*Of 51 major announcements of financial support from donor agencies to developing countries that WaterAid have tracked only six have included any mention of hygiene. This only includes announcements that have been made public and can therefore be tracked and does not include any money released by governments of developing countries directly for COVID-19 response.  WaterAid’s country teams across Africa and Asia are also reporting a lack of prioritisation of expanding clean water and hygiene services to the most marginalised within their national government responses 


WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 28 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 26.4 million people with clean water and 26.3 million people with decent toilets. For more information, visit, follow @WaterAid or @WaterAidPress on Twitter, or find WaterAid UK on Facebook at

  • 785 million people in the world – one in ten – do not have clean water close to home.[1]
  • 2 billion people in the world – almost one in four – do not have a decent toilet of their own.[2]
  • Around 310,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's almost 800 children a day, or one child every two minutes.[3]
  • Every £1 invested in water and toilets returns an average of £4 in increased productivity.[4]
  • Just £15 can provide one person with clean water.[5]

[1] WHO/UNICEF Joint Monitoring Programme (JMP) Progress on drinking water, sanitation and hygiene: 2017 update and SDG Baselines

[2] WHO/UNICEF Joint Monitoring Programme (JMP) Progress on drinking water, sanitation and hygiene: 2017 update and SDG Baselines

[3] Prüss-Ustün et al. (2014) and The Institute for Health Metrics and Evaluation (2018)

[4] World Health organization (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage