Bulletin of the World Health Organization

Local production of WHO-recommended alcohol-based handrubs: feasibility, advantages, barriers and costs

Joanna Bauer-Savage, Didier Pittet, EunMi Kim & Benedetta Allegranzi

Volume 91, Number 12, December 2013, 963-969

Table 1. Advantages of – and potential barriers to – the local production of alcohol-based handrubs, 2011

Advantages and barriers No. of sites/total that provided data (%) Countries (no. of sites)
Advantages
Less expensive than marketed alcohol-based handrubs 7/9 (78) Brazil (1), Cambodia (3), Islamic Republic of Iran (1), Mongolia (1), Pakistan (1)
Excellent tolerance and acceptability 31/38 (82) Argentina (1), Bangladesh (1), Brazil (2), Cambodia (3), China (Province of Taiwan) (1), Colombia (1), Ethiopia (1), Indonesia (2), Italy (1), Japan (1), Jordan (1), Kenya (1), Lebanon (1), Malawi (1), Mali (1), Mongolia (1), Nigeria (3), Oman (1), Pakistan (1), Saudi Arabia (1), Senegal (1), Sudan (1), Thailand (1), Tunisia (1), Turkey (1)
Used in health facility as part of a multimodal approach to improve hand hygiene 30/34 (88) Argentina (1), Brazil (1), Cambodia (6), Colombia (1), Ethiopia (1), Indonesia (2), Islamic Republic of Iran (1), Italy (1), Japan (1), Kenya (1), Lebanon (1), Malawi (1), Mali (1), Mongolia (1), Nigeria (1), Pakistan (1), Philippines (1), Saudi Arabia (1), Senegal (1), Sudan (2), Tunisia (1), Turkey (1), Uganda (1)
Manufactured from locally-sourced alcohola 28/39 (72) Argentina (1), Brazil (2), Cambodia (6), China (Province of Taiwan) (1), Colombia (1), Ethiopia (1), Indonesia (2), Italy (1), Japan (1), Kenya (1), Lebanon (1), Malawi (1), Mali (1), Nigeria (2), Philippines (1), Saudi Arabia (1), Sudan (1), Tunisia (1), Turkey (1), Uganda (1)
Barriers
to production
    Staff needed training on production process 29/39 (74) Argentina (1), Bangladesh (1), Belgium (1), Brazil (1), Cambodia (6), Colombia (1), Ethiopia (1), Indonesia (1), Islamic Republic of Iran (1), Italy (1), Jordan (1), Kenya (1), Lebanon (1), Malawi (1), Mali (1), Mongolia (1), Nigeria (2), Oman (1), Pakistan (1), Saudi Arabia (1), Sudan (1), Tunisia (1), Turkey (1)
    Occasional difficulty in procuring ingredients locally 20/39 (51) Brazil (1), Cambodia (6), China (Province of Taiwan) (1), Colombia (1), Ethiopia (1), Indonesia (1), Japan (1), Kenya (1), Malawi (1), Mali (1), Mongolia (1), Nigeria (1), Senegal (1), Sudan (1), Turkey (1)
    Difficulty in procuring appropriate dispensers 19/37 (51) Brazil (2), Cambodia (4), Ethiopia (1), Indonesia (1), Kenya (1), Malawi (1), Mali (1), Mongolia (1), Nigeria (2), Pakistan (1), Philippines (1), Saudi Arabia (1), Senegal (1), Uganda (1)
to quality control
    Suboptimal reprocessing of dispensersb 11/24 (46) Brazil (2), Cambodia (4), Colombia (1), Ethiopia (1), Nigeria (1), Saudi Arabia (1), Sudan (1)
    Quality control not performed on site (mainly due to lack of equipment) 11/24 (46) Argentina (1), Ethiopia (1), Islamic Republic of Iran (1), Japan (1), Lebanon (1), Malawi (1), Nigeria (2), Pakistan (1), Sudan (1), Turkey (1)
to acceptability
    Unpleasant smell 4/38 (11) Belgium (1), Cambodia (1), Philippines (1), Uganda (1)

a Alcohol produced from sugar cane, maize, manioc, mahogany or walnut.

b The simple washing of used dispensers, with no attempt at disinfection or sterilization.