I doubt there are many situations that make us feel more vulnerable and helpless than when we’re in hospital. Our control over our lives is stripped away and everything about our existence is in the hands of those working at and running the facility; not just the surgeons, doctors and nurses directly involved in curing our physical/mental ailments and/or injuries, but the caterers, porters and cleaning teams – and those organising them, too. If one part’s not up to scratch it could perhaps be the end of us! I’m lucky, living where I do, to be able to enjoy decent facilities, so it’s more my own body I’m concerned about letting me down than I am the skills and efforts of anyone else, but that’s not the case for everyone, is it? 

  

A global progress report: ‘Essential Services for Quality Care: Water, Sanitation, Hygiene, Health Care Waste & Electricity Services in Health Care Facilities’, issued yesterday by the World Health Organisation with UNICEF, warns that despite unprecedented efforts to establish standards, conduct baseline assessments and develop national roadmaps, billions are still served by facilities without the basics. For example as recently as 2023, an estimated 1.1-billion people were served by healthcare facilities lacking basic water services, 3-billion lacked basic sanitation services, 1.7-billion lacked basic hygiene services and 2.8-billion lacked basic waste services. Many facilities either had no electricity whatsoever or an unreliable supply. It’s hard to imagine having to clean a facility without electricity, but to have no water either… How on earth…? 

  

Commitment is growing though… In 2025, 101 countries provided validated data on WASH, waste & electricity in health facilities; more than double the 47 countries that did so in 2020, and more than 80% of countries had implemented at least one national action, such as developing standards or conducting baseline assessments. Several ‘Least Developed Countries’ (including Ethiopia, Malawi, Nepal, Rwanda and Uganda) are among those showing strong readiness to implement and scale-up WASH, waste & electricity improvements. Funding, though, remains the greatest gap: While over half of countries have approved national plans, only one in five reports adequate dedicated financing to implement them. And without the money, what improvements can effectively be made - and, just as importantly, sustained? 

  

As part of the report’s launch, a meeting was held yesterday in New York, convened by Hungary and the Philippines as co-chairs of the Group of Friends in Support of WASH in Health Care Facilities. It brought together governments, agencies and partners with a view to accelerating progress, closing financing gaps and ensuring that every health facility worldwide has the services needed to provide safe, quality and dignified care. Sadly, having read the report and studied the background to it, I’m aware that there's a long way to go. I'm equally aware, too, that sometimes we don't realise just how lucky we are...