doi: 10.1136/bmjgh-2025-018930.
We have the evidence but governments must now build the systems to deliver on hand hygiene
Joanna Esteves Mills
1
, Bruce Gordon
2
, Lindsay Denny
3
, Ann Thomas
3
, Arnold Oredola Cole
4
, Andrea Lee-Llacer
5
, Sophie Hickling
6
, Alemu Kejela Ababu
7
8
, Akosua Kwakye
9
, Alyaa Mohamed
10
, Aarin Palomares
11
, Nathaniel Paynter
3
, Om Prasad-Gautam
6
, Siddhi Shrestha
12
, Precious Kalubula
13
14
, Bethany A Caruso
15
, Matthew C Freeman
16
, Marlene K Wolfe
17
, Sudan Raj Panthi
18
, Marysol Astrea Liwanag Balane
19
, Jon Michael Villasenor
20
, Kidist Bartolomeus
21
, Anthony Eshofonie
22
, Bonifacio Magtibay
23
, Sory Bouare
24
, Doussou Doumbia
25
, Kachusha Nkosha
26
, Rajit Ojha
27
, Suzzy Abaidoo
28
, Waltaji Kutane
29
, Mahamane Toure
30
, Issaka Sangare
30
, Sanjani Limbu
31
, Ahammadul Kabir
22
, Seema Ranjouria
32
, Doreen Mulemba
33
, Suzan Alzubaidy
34
, Olga Kokshagina
35
36
, Leah Heiss
36
, Elisabetta Minelli
21
, Charles Nachinab
37
, Oliver Cumming
38
39
Affiliations
Affiliations
- 1 Water, Sanitation, Hygiene and Health Unit, Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland jestevesmills@gmail.com.
- 2 Water, Sanitation, Hygiene and Health Unit, Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
- 3 UNICEF, New York, New York, USA.
- 4 UNICEF East and Southern Africa Regional Office, Nairobi, Kenya.
- 5 Government of the Philippines, Manila, Philippines.
- 6 WaterAid United Kingdom Office, London, UK.
- 7 WASH and Environmental Health, Government of Ethiopia, Addis Ababa, Ethiopia.
- 8 WASH and Environmental Health, Ethiopia Ministry of Health, Addis Ababa, Ethiopia.
- 9 World Health Organization Country Office for Ghana, Accra, Ghana.
- 10 World Health Organization Country Office for Iraq, Baghdad, Iraq.
- 11 Global Handwashing Partnership, Washington, Washington, USA.
- 12 UNICEF Nepal Country Office, Lalitpur, Nepal.
- 13 Health Emergencies, World Health Organization, Geneva, Zambia.
- 14 Public Health, Zambia Ministry of Health, Lusaka, Zambia.
- 15 HUbert Department of Global Health, Emory University, Atlanta, Georgia, USA.
- 16 Gangarosa Department of Environmental Health, Emory Univ, Atlanta, Georgia, USA.
- 17 Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
- 18 Environmental Health, World Health Organization, Kathmandu, Nepal.
- 19 UNICEF Philippines Country Office, Manila, Philippines.
- 20 UNICEF Philippines Country Office, Mandaluyong, Philippines.
- 21 Product Design and Impact Unit, Science Division, World Health Organization, Geneva, Switzerland.
- 22 World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh.
- 23 World Health Organization Country Office for Philippines, Manila, Philippines.
- 24 World Health Organization Country Office for Mali, Bamako, Mali.
- 25 National Health Directorate, Government of Mali, Bamako, Mali.
- 26 WaterAid Zambia Country Office, Lusaka, Zambia.
- 27 Ministry of Water Supply, Government of Nepal, Kathmandu, Nepal.
- 28 Ministry of Sanitation and Water Resources, Government of Ghana, Accra, Ghana.
- 29 World Health Organization Country Office for Ethiopia, Addis Ababa, Ethiopia.
- 30 WaterAid Mali Country Office, Bamako, Mali.
- 31 WaterAid Nepal Country Office, Kathamandu, Nepal.
- 32 WaterAid Nepal Country Office, Kathmandu, Nepal.
- 33 Ministry of Water and Sanitation, Government of Zambia, Lusaka, Zambia.
- 34 Ministry of Health, Government of Iraq, Baghdad, Iraq.
- 35 University of Sydney, Sydney, New South Wales, Australia.
- 36 Monash University, Melbourne, Victoria, Australia.
- 37 UNICEF Ghana Country Office, Accra, Ghana.
- 38 London School of Hygiene and Tropical Medicine, London, UK.
- 39 Department of Disease Control, Environmental Health Group, London School of Hygiene & Tropical Medicine, London, UK.
- PMID: 40957687
- DOI: 10.1136/bmjgh-2025-018930
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We have the evidence but governments must now build the systems to deliver on hand hygiene
Joanna Esteves Mills et al.
BMJ Glob Health.
.
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doi: 10.1136/bmjgh-2025-018930.
Authors
Joanna Esteves Mills
1
, Bruce Gordon
2
, Lindsay Denny
3
, Ann Thomas
3
, Arnold Oredola Cole
4
, Andrea Lee-Llacer
5
, Sophie Hickling
6
, Alemu Kejela Ababu
7
8
, Akosua Kwakye
9
, Alyaa Mohamed
10
, Aarin Palomares
11
, Nathaniel Paynter
3
, Om Prasad-Gautam
6
, Siddhi Shrestha
12
, Precious Kalubula
13
14
, Bethany A Caruso
15
, Matthew C Freeman
16
, Marlene K Wolfe
17
, Sudan Raj Panthi
18
, Marysol Astrea Liwanag Balane
19
, Jon Michael Villasenor
20
, Kidist Bartolomeus
21
, Anthony Eshofonie
22
, Bonifacio Magtibay
23
, Sory Bouare
24
, Doussou Doumbia
25
, Kachusha Nkosha
26
, Rajit Ojha
27
, Suzzy Abaidoo
28
, Waltaji Kutane
29
, Mahamane Toure
30
, Issaka Sangare
30
, Sanjani Limbu
31
, Ahammadul Kabir
22
, Seema Ranjouria
32
, Doreen Mulemba
33
, Suzan Alzubaidy
34
, Olga Kokshagina
35
36
, Leah Heiss
36
, Elisabetta Minelli
21
, Charles Nachinab
37
, Oliver Cumming
38
39
Affiliations
- 1 Water, Sanitation, Hygiene and Health Unit, Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland jestevesmills@gmail.com.
- 2 Water, Sanitation, Hygiene and Health Unit, Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
- 3 UNICEF, New York, New York, USA.
- 4 UNICEF East and Southern Africa Regional Office, Nairobi, Kenya.
- 5 Government of the Philippines, Manila, Philippines.
- 6 WaterAid United Kingdom Office, London, UK.
- 7 WASH and Environmental Health, Government of Ethiopia, Addis Ababa, Ethiopia.
- 8 WASH and Environmental Health, Ethiopia Ministry of Health, Addis Ababa, Ethiopia.
- 9 World Health Organization Country Office for Ghana, Accra, Ghana.
- 10 World Health Organization Country Office for Iraq, Baghdad, Iraq.
- 11 Global Handwashing Partnership, Washington, Washington, USA.
- 12 UNICEF Nepal Country Office, Lalitpur, Nepal.
- 13 Health Emergencies, World Health Organization, Geneva, Zambia.
- 14 Public Health, Zambia Ministry of Health, Lusaka, Zambia.
- 15 HUbert Department of Global Health, Emory University, Atlanta, Georgia, USA.
- 16 Gangarosa Department of Environmental Health, Emory Univ, Atlanta, Georgia, USA.
- 17 Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
- 18 Environmental Health, World Health Organization, Kathmandu, Nepal.
- 19 UNICEF Philippines Country Office, Manila, Philippines.
- 20 UNICEF Philippines Country Office, Mandaluyong, Philippines.
- 21 Product Design and Impact Unit, Science Division, World Health Organization, Geneva, Switzerland.
- 22 World Health Organization Country Office for Bangladesh, Dhaka, Bangladesh.
- 23 World Health Organization Country Office for Philippines, Manila, Philippines.
- 24 World Health Organization Country Office for Mali, Bamako, Mali.
- 25 National Health Directorate, Government of Mali, Bamako, Mali.
- 26 WaterAid Zambia Country Office, Lusaka, Zambia.
- 27 Ministry of Water Supply, Government of Nepal, Kathmandu, Nepal.
- 28 Ministry of Sanitation and Water Resources, Government of Ghana, Accra, Ghana.
- 29 World Health Organization Country Office for Ethiopia, Addis Ababa, Ethiopia.
- 30 WaterAid Mali Country Office, Bamako, Mali.
- 31 WaterAid Nepal Country Office, Kathamandu, Nepal.
- 32 WaterAid Nepal Country Office, Kathmandu, Nepal.
- 33 Ministry of Water and Sanitation, Government of Zambia, Lusaka, Zambia.
- 34 Ministry of Health, Government of Iraq, Baghdad, Iraq.
- 35 University of Sydney, Sydney, New South Wales, Australia.
- 36 Monash University, Melbourne, Victoria, Australia.
- 37 UNICEF Ghana Country Office, Accra, Ghana.
- 38 London School of Hygiene and Tropical Medicine, London, UK.
- 39 Department of Disease Control, Environmental Health Group, London School of Hygiene & Tropical Medicine, London, UK.
- PMID: 40957687
- DOI: 10.1136/bmjgh-2025-018930
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Conflict of interest statement
Competing interests: None declared.
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