WASH in healthcare facilities can help prevent antimicrobial resistance

WASH in healthcare facilities can help prevent antimicrobial resistance

Subject: Science and technology

Section: health 

Context:

• The importance of preventing infections has become more crucial, with the existing antibiotics becoming increasingly ineffective due to the growing burden of antimicrobial resistance (AMR) and the thin and dry drugs in the pipeline.

Antimicrobial resistance (AMR):

• Prevention refers to practices that can limit or avert the emergence and spread of infections, such that antimicrobial use can be reduced.
• AMR occurs when bacteria, viruses, fungi and parasites develop resistance against the antimicrobial drugs and no longer be inactivated or killed by the drug.
• Causes of spread:
  • Overuse and misuse of drugs in humans, animals and the food production sectors.
  • The environment also accelerates the emergence and spread of AMR.
• Consequences:
  • In 2019, about five million deaths worldwide were estimated to be associated with antibiotic resistance. About 1.3 million deaths were directly attributed to it.

WASH strategy to prevent AMR:

• Water, sanitation and hygiene (WASH) in healthcare facilities, households and communities, and food-animal production systems play a fundamental role in AMR prevention and containment.
• Universal access to clean drinking water, better sanitation and hygiene can control the development and spread of infections and subsequent antibiotic use.
• A recent report by the World Health Organization and UNICEF has reaffirmed this. Water, Sanitation, Hygiene, Waste and Electricity Services in Health Care Facilities: 2023 Global Progress Report assessed global and national efforts and progress towards improving WASH, cleanliness and waste management, particularly in health care facilities.
  • Healthcare-associated infections that occur while receiving care for another condition are a major threat; they call for the use of antibiotics.
  • Waste (mostly sewage and effluents) can be a major source of AMR.
  • Improper disposal of healthcare-associated waste such as gloves, syringes and vials.
• The status of least developed countries (LDC) —low-income countries:
  • Only 21 per cent of healthcare facilities have basic sanitation services, whereas basic hygiene services are available in just a third (32 per cent) of healthcare facilities in these countries.
  • Only 14 per cent of countries monitored WASH in health systems in 2022.
  • In terms of health budgets, only 12 per cent of countries have more than 75 per cent of the funds needed to reach WASH targets.
  • Universal access to WASH in healthcare facilities will cost $0.60 per person per year for LDCs — equivalent to 6 per cent of their current annual health spending.
• Steps to prevent AMR:
  • Safely managed sanitation systems, even simple ones using well-maintained septic tanks, will reduce pathogen loads and help prevent the spread of antimicrobial-resistant pathogens (and other pathogens) in wastewater.
  • Improving investments, integration into health planning, building the right set of the health workforce and strengthening the review and monitoring process to deliver and maintain better WASH, waste and electricity services.