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UK aid must play a fundamental role in the fight against antibiotic resistance – WaterAid

Sol Oyuela, Global Director of Policy & Campaigns | WaterAid

4 min read Partner content

Ignoring this global crisis of antibiotic resistance will threaten the health of us all, says Sol Oyuela, Global Director of Policy & Campaigns at WaterAid.


The news this week that nearly 900 million people around the world have no water at all at their local health facility is staggering – and a wake-up call for anyone who thinks efforts at addressing antibiotic resistance can be successful as long as this remains the case.

Here in the UK, in hospitals and GP surgeries, so much focus is placed on only prescribing antibiotics when necessary, and upon the essential need for rigorous hygiene to help stop the spread of infection in the first place.

It is hard to imagine how dedicated health professionals in other parts of the world can do the same when their hospital or clinic doesn’t have a clean, reliable source of water on site. New data released this week shows that 45% of healthcare facilities in least-developed countries, and one in four around the world, do not have a clean source of water on site. One in five health facilities around the world do not have toilets, and one in six do not have facilities to allow for handwashing with soap.

Infections spread quickly in facilities without access to water, decent sanitation, hygiene and proper waste management procedures, with devastating results: globally, 225,000 babies die of sepsis in their first four weeks of life, most of those in sub-Saharan Africa and South Asia. Many of these deaths might have been prevented had they been born into a clean environment, where birthing attendants were able to wash hands properly with soap and water.

Rising rates of so-called superbugs have also been directly attributed to poor sanitary conditions in healthcare facilities, leading to the overuse and misuse of antibiotics to prevent and treat infections which might have been avoided with proper hygiene practice. A recent British Medical Journal article found almost 16 babies in every 1,000 born in South Asia test positive for sepsis, and one-third of these babies will die.

We also know that 800 children a day die of diarrhoeal diseases directly linked to dirty water, poor sanitation and poor hygiene.

The battle to save lives, and to slow the rise of deadly superbugs, cannot be won as long as these dedicated frontline staff are denied what we consider the fundamentals of health care: a reliable source of clean water on site, decent toilets, rigorous hygiene procedures, proper disposal of waste and careful cleaning.  All the research to develop new drugs in the race to beat antibiotic resistance will be in vain if these drugs continue to be overused and misused in the absence of good hygiene.

The UK Government, in its 5-year action plan on tackling antimicrobial resistance, has committed to support greater access to clean water and sanitation, and has also pledged to make this issue a priority by supporting a World Health Assembly resolution on this issue next month.

But we need to go farther and translate commitments into action: this must be a global priority with appropriate financing. Our investments in health must prioritise clean water, decent toilets, good hygiene behaviours and incentivise stronger coordination between programmes focusing on health and water, sanitation and hygiene. As a world leader on health, the UK can champion this approach and ensure that every child born in the developing world has a healthy start to life, but we must lead by example.

UK aid can and must play a fundamental role in the fight against antibiotic resistance. As the UK Government considers its next spending review, it must reaffirm its commitment in water, sanitation and hygiene, to play our part as global leaders in ensuring every community, every school and every health facility has these basic pillars of development.

Good aid done well saves lives. And ignoring this global crisis will threaten the health of us all.

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