“Wash your hands with soap” may seem like simplistic or inadequate advice when media headlines report the relentless global spread of COVID-19. Surely, there must be a more sophisticated response?
It also prevents many other infectious diseases that cause millions of deaths each year, such as diarrhea, cholera, and typhoid.
But this simple method to avoid spreading disease remains out of reach for about 3 billion people globally. These are people who lack even basic handwashing facilities with soap and water in their home – especially in Sub-Saharan Africa.
That’s because handwashing requires easy access to a clean and reliable water supply, which is also needed to clean and disinfect surfaces where germs and viruses settle.
Safely managed water, sanitation, and hygiene (WASH) services are an essential part of preventing disease and protecting human health during infectious disease outbreaks. And investing in core public health infrastructure, including water and sanitation systems, is one of the most cost-effective strategies for increasing pandemic preparedness, especially where resources are limited.
Too often, however, these services are lacking even in the places where people go to seek treatment. A recent report finds that around one in four health care facilities globally lacked basic water services, while more than one in five had no sanitation service.
During an infectious disease outbreak such as COVID-19, an effective emergency response can focus on providing rapid, low-cost water service provision for communities, health care facilities, and schools that lack a reliable and safe supply. And as fixed and portable handwashing facilities, soap and alcohol-based hand rubs, and water supplies are secured, educational and behavioral tools and tactics can help people understand that handwashing can be the difference between life and death.
It is also vital that water and sanitation utilities receive enough support to ensure continuity of water supplies. This means focusing on better monitoring, staffing levels, and maintenance where water utilities exist, and conducting assessments and ensuring rapid delivery of services where they don’t – for example, in countries coping with fragility, conflict, and violence. In these challenging contexts, just-in-time solutions could include the provision and operation of compact water treatment plants, construction and operation of water points in strategic locations, and use of trucks to deliver water in small containers or storage tanks.
The World Bank’s Emergency Health and Nutrition Project in Yemen is an example of rapid response to an ongoing health epidemic – in this case, cholera - aiming at preparedness and prevention in an FCV context. The project focuses on bulk chlorination of water sources and supporting essential staff costs for keeping key services and facilities running. The Yemen Wash Poverty Diagnostic funded by Global Water Security and Sanitation Partnership (GWSP) helped make the case for two rounds of IDA financing for water and sanitation under this project – an initial $100m for FY18 plus an additional $37m in FY19. GWSP also catalyzed other analytical work, including lessons and insights around partnerships, resilience and the service chain.
Resources are also needed during a pandemic response to ensure that WASH services continue to function. The drastic effects of supply chain disruptions, depressed economic activity, and even panic-buying can worsen the quality and continuity of water and sanitation services. Whether through financial support to utilities, making treatment chemicals or fuel available, providing free WASH services to households and institutions that are most in need, or ensuring that soap and disinfectant are available, there are many interventions that can limit the spread of disease.
Safely managed WASH services are needed to help affected, at-risk, and low-capacity countries build resilience against pandemics. And these services also offer the poor an effective way to tackle more routine threats to survival, such as diarrhea, which in 2016 was the second leading cause of death in low-income countries, killing nearly 60 out of every 100,000 people.
Hence improving water and sanitation is key to long-term gains in public health as well as critical to addressing the current crisis.
Learn more about WASH (Water, Sanitation & Hygiene) and COVID-19