Donors are ignoring hygiene in the fight against COVID-19

BELFAST, Northern Ireland — Despite being critical in the fight against COVID-19, efforts to improve hygiene are mostly absent in donor commitments to tackle the coronavirus, according to WaterAid. Instead, the focus is on vaccines.

“Vaccines and therapeutics are clearly essential in ending this pandemic, but until they are available the only defence we have against COVID-19 is prevention,” said Tim Wainwright, CEO of WaterAid UK, in a statement. “Three billion people have nowhere to wash their hands with soap and water at home, and many doctors and nurses in developing countries work in a healthcare centre without the most basic hygiene provision.”

Little money has been released to address this, Wainwright said. According to WaterAid’s internal donor tracking, only eight out of 53 major donor commitments to COVID-19 mention hygiene. The European Union, Gavi, and the U.K.’s Department for International Development, in partnership with Unilever, are among those with commitments that look to support improved access to water, sanitation, and hygiene, while other pledges from the African Development Bank and the Bill & Melinda Gates Foundation fail to do so.

“While this isn’t a comprehensive, scientific analysis, I think it shows starkly the lack of prioritization and investment in hygiene as a first line of defense against COVID-19, particularly when you compare that to the billions of euros being pledged for vaccines,” Dan Jones, advocacy coordinator at WaterAid, said. Through the Coronavirus Global Response initiative, more than $8 billion has been pledged for the development of diagnostics, treatments, and vaccines.

Very few countries mentioned the role of hygiene in their opening statements at this month’s virtual World Health Assembly, Jones said. “This is disappointing. … It’s essentially saying this isn’t a priority, which shouldn’t be the case,” he said.

But Dr. Alpha Tejan Wurie, Sierra Leone’s minister of health and sanitation, did highlight the need for increased hygiene practices and lessons on containment that the country learned from Ebola, while representatives from Cambodia and Zambia briefly mentioned the importance of infection, prevention, and control measures.

In the long term, more heads of state and of donor agencies need to highlight the importance of water, sanitation, and hygiene in COVID-19 responses, Jones said, yet it is up to the sector to drive this argument home.

The first draft of a formal resolution on COVID-19 failed to mention the role of WASH. Following advocacy efforts, this was rectified in the final version released at the World Health Assembly. Jones said it was “disturbing” that WASH had initially been disregarded when only a year ago — at the 72nd World Health Assembly — ministers of health signed a resolution on WASH in health care facilities.

Al-Hassan Adam, international coordinator at End Water Poverty — a coalition of civil society organizations that campaigns for sustainable WASH — called on sector professionals to keep putting pressure on countries to improve access to water and hygiene facilities.

“Keep reminding them that they need to do something now and post-COVID. ... History has told us that we seize the opportunity when there’s a crisis and governments will sit up and do what they’re expected to do,” Adam said.

“In the short-term, governments and donors should be doubling their investments in WASH as part of their COVID-responses. … It’s about donors and governments fulfilling their existing commitments to WASH, which they haven’t been doing,” Jones said.

Prior to the pandemic, financing for WASH was already lacking — less than 15% of countries had the financing needed to implement their national WASH plans, according to the United Nations’ GLAAS report. It notes a recent uptick in donor funding for WASH, which accounted for 4.5% of overall official development assistance in 2017 — but that follows several years of decline. Now, there are fears that the pandemic will lead to a concentration of ODA on health interventions, at the expense of other sectors.

The Gavi replenishment on June 4 marks another opportunity to emphasize that hygiene should go hand in hand with vaccines, Jones said. “When there’s a COVID-19 vaccine, it should be rolled out in an integrated way, so it should be the vaccine plus very strong hygiene promotion with the facilities for people to be able to wash their hands,” he said.

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