Post-COVID Recovery not Possible if WASH not High on Agenda

This World Health Day, G20 finance ministers met in Rome, Italy, to discuss how they will build back from the pandemic. The global economy is in distress and concerted effort, coordination and imagination are needed to enable not only a worldwide recovery but also to ensure that the world’s poorest people are not left behind. The World Health Organization has today urged countries to build a fairer, healthier world post-COVID-19. But this simply will not be possible if water, sanitation and hygiene are not high on the agenda.

Globally one in four healthcare facilities has no clean water on site. Indeed,1.8 billion people are at higher risk of COVID-19 and other infectious diseases because they use or work in a healthcare facility which lacks basic water services.

Trying to create a robust pandemic preparedness and response plan without ensuring that every healthcare facility has clean water and the ability to keep its patients, frontline health workers and premises clean is like building a fortress with a gaping hole where the door should be.

But in the world’s poorest countries – half of all hospitals and clinics have no clean water. This reality leaves healthcare workers and their patients, including mothers and newborns, at risk daily from deadly diseases and infections.

It also eases the way for new strains of disease to emerge and spread without the barriers of hygiene to overcome, creating risks not only for that community but frighteningly quickly, as we have seen with COVID-19, the rest of the world.

An investment of $1.2 billion from the G20 leaders would transform this situation. This amount would be enough to ensure every healthcare facility in the world’s poorest countries had the taps, toilets and handwashing facilities they so desperately need.

This might sound like a lot of money. But since the onset of Covid-19, rich countries have mobilised such huge sums, an average of nearly 10% of their GDP1, and a total of $20.6 trillion. The $1.2 billion investment WaterAid is calling for equates to just thirty minutes-worth of the past year’s spending.

Not only has research shown that washing hands with soap helps reduces the spread of coronaviruses by one third3 , it also helps limit the growing threat of antimicrobial resistance.

Antibiotics are too often used in unclean health facilities in place of proper hygiene practices, and are losing their power to fight infections worldwide. This essential injection of finance by the G20 would prevent millions of avoidable deaths through infections and diseases.

According to the World Health Organization, an investment of this nature would take just one year to pay for itself and produce savings for every dollar invested thereafter.4 But an ever-growing debt crisis is preventing poorer countries from being able to invest in basic water services, with some countries paying billions of dollars in international debt service each year.

Zambia, for example, paid over $2 billion in 2019, a staggering 11% of its Gross National Income and has since defaulted on its payments. Pakistan paid a huge $11 billion to service their debt in the same year – an amount which could pay for access to taps, toilets and handwashing facilities in hospitals across all of the least developed countries three times over.

A global poll of over 18,000 adults across 15 countries including the UK, Brazil, Nigeria, India, Australia and the USA,5 commissioned by WaterAid and conducted by YouGov, reveals that 75% of those surveyed believe that debt payments by the poorest countries (including to private sector creditors) should be suspended so that countries can invest more of their scarce resources into essentials like water and soap.

The poll showed that, for example, in Nigeria 87% of those polled agreed that their annual $5 billion debt servicing payments should be suspended. 80% of those polled in India agreed with the proposition.

True debt relief and restructuring, which the G20 could agree6, would radically change the economic prospects of poorer nations. With the means to invest, those countries could then make strategic economic decisions to tackle the immediate crisis whilst also protecting against future pandemics.

Debt service payments to governments are currently suspended but this suspension is due to end in June even as the global pandemic continues.

Investing in water, sanitation and hygiene is an obvious investment for governments and presents the opportunity both to save lives now and protect against future pandemics along with the devastation they cause.

It is vital that we make sure that getting universal access to soap and water to is given the same levels of drive and ambition that are accompanying the creation of vaccines, as well the finance that is being offered for stimulus packages and economic response.

The G20 leaders have an opportunity to make a difference this week. By committing to comprehensive debt relief along with new funding of at least $1.2 billion they can make sure all healthcare facilities in the poorest countries have clean water and soap before another pandemic hits.

1 9.7% according to study https://unctad.org/fr/node/31523 and Statista has Japan as largest at 20.9% of its GDP: https://www.statista.com/statistics/1107572/covid-19-value-g20-stimulus-packages-share-gdp/

3 Beale S, Johnson A, Zambon M, null n, Hayward A, Fragaszy E. Hand Hygiene Practices and the Risk of Human Coronavirus Infections: https://wellcomeopenresearch.org/articles/5-98

4 p3 https://washmatters.wateraid.org/sites/g/files/jkxoof256/files/everyone-everywhere-achieving-universal-health-coverage-through-water-sanitation-and-hygiene-uhc-day-action-plan_0.pdf Taken from WHO 2020 Combatting Antimicrobial Resistance through water, sanitation and hygiene and infection prevention and control in health care

5 Based on polling conducted by YouGov for WaterAid: 18,635 adults surveyed across 15 countries: Australia, Brazil, Canada, France, Germany, India, Italy, Japan, South Korea, Nigeria, Saudi Arabia, Sweden, South Africa, UK, USA.   based on polling conducted by YouGov for WaterAid: 18,635 adults surveyed across 15 countries: Australia, Brazil, Canada, France, Germany, India, Italy, Japan, South Korea, Nigeria, Saudi Arabia, den, South Africa, UK, USA.  www.washmatters.wateraid.org/publications/public-support-wash-resilience.

6 https://www.imf.org/en/About/FAQ/sovereign-debt#g20q1

(The writer is Senior Policy Analyst – Health & Hygiene, WaterAid)