Event highlights
Robust water, sanitation and hygiene (WASH) services in health-care facilities are not merely beneficial but are, in fact, an absolute precondition for infection prevention and control (IPC) and the delivery of safe, dignified and high-quality care. Strong WASH systems are indispensable in protecting child and maternal health, mitigating the overuse or unnecessary use of antibiotics, and averting hospital-acquired infections. To support efforts to advance WASH services in the WHO European Region, WHO brought together more than 60 experts from 12 countries and 13 partner organizations.
The meeting in Budapest, Hungary, took place under the auspices of the Protocol on Water and Health and in close collaboration with the Hungarian Ministry of Interior and the National Centre for Public Health and Pharmacy. Three key messages provided a clear blueprint for collective action.
Dignity, resilience and workforce support
Firstly, access to clean water, adequate sanitation and proper hygiene practices are fundamental human rights that underpin the dignity of both patients and health-care workers. Ensuring these services are consistently available and maintained is crucial for providing respectful and compassionate care. This also extends to adequate menstrual hygiene management – which is essential for the dignity and well-being of all individuals in health-care settings – including access to clean water, sanitation facilities and menstrual products. WHO/Europe has been supporting health ministries in a number of countries to undertake comprehensive situational analyses to identify priorities and gaps to work towards better standards of WASH services in health-care facilities.
Secondly, health-care facilities must be inherently resilient to withstand emergencies and the escalating impacts of climate change. Investing in climate-resilient WASH infrastructure is not merely a preventative measure but a strategic imperative, helping facilities adapt to extreme weather events, ensuring their continuous operation and enabling them to provide uninterrupted care during crises. Integrating WASH into health emergency preparedness and response strategies is vital for managing outbreaks, natural disasters and other crises, thereby reducing the risk of secondary infections and safeguarding the safety of both patients and staff.
Thirdly, proper WASH services are paramount for the health and safety of health-care workers, serving as a primary defence against infections and occupational hazards. Providing comprehensive training on WASH practices equips health-care workers with the essential knowledge and skills needed to maintain high standards of hygiene and safety. By prioritizing WASH services, health-care facilities demonstrate an unwavering commitment to the well-being of their invaluable staff, fostering a positive and safe work environment that, in turn, enhances the overall quality of care delivered to patients.
“Improving WASH in health-care settings must go hand in hand with efforts on IPC, and antimicrobial resistance [AMR],” notes Oliver Schmoll, Programme Manager for Water and Climate, WHO European Centre for Environment and Health .“IPC simply doesn’t work without reliable WASH. Millions of health-care-associated infections [HAIs] could be prevented each year if we got this right.”
In the European Union and European Economic Area (EU/EEA), more than 3.5 million cases of HAIs occur annually, leading to over 90 000 deaths, and with AMR remaining a severe threat, with over 35 000 deaths in the EU/EEA each year directly attributable to resistant infections, the critical need for effective WASH and IPC interventions is clear.
A collaborative path forward
The timing of this gathering carried symbolic weight, taking place directly after the birthday of Ignaz Semmelweis. This Hungarian physician, revered as the “saviour of mothers”, pioneered antiseptic procedures in the mid-19th century. His insistence on handwashing with chlorinated lime solutions in obstetrical clinics dramatically slashed postpartum infections, laying the bedrock for modern infection control. Despite fierce resistance from his contemporaries, Semmelweis’s foresight continues to inspire, serving as a powerful reminder of the fundamental and life-saving impact of proper hygiene in medical settings.
The stark reality is that missing or inadequate WASH provisions render care less effective, less safe and potentially even harmful. This understanding is not new, but recent years have seen a surge in global and regional consensus and political momentum on the urgent need to improve WASH services. The 2019 World Health Assembly resolution on WASH in health-care facilities significantly steered progress, in concert with a 2023 United Nations General Assembly resolution on sustainable, safe and universal water, sanitation, hygiene, waste and electricity services in health-care facilities, spearheaded by the Group of Friends in Support of WASH in Health Care Facilities co-led by Hungary.
Building a healthier future for all
Despite these strong commitments, progress across the European Region remains uneven. According to the WHO/United Nations Children’s Fund Joint Monitoring Programme 2023 data, 14 countries reported more than 96% of health-care facilities having basic drinking-water. Yet, in the European Region, 10% of health-care facilities still have no services for water and 13% no sanitation services. In central Asia, some countries have reported that up to 57% of facilities lack water services and 65% lack sanitation services. Significant data gaps persist, but the limited data available reveals disparities in both access to and quality of WASH services across various facilities and geographic areas.
The Budapest meeting stands as a powerful testament to the enduring power of collaboration. It underscores the foundational importance of WASH in building a healthier future for all, a future where every health-care facility upholds dignity, demonstrates resilience and champions the well-being of its workforce, truly honouring the legacy of Ignaz Semmelweis and his life-saving call for clean hands.