Each year on May 5, World Hand Hygiene Day is observed globally, spearheaded by the World Health Organization (WHO) to highlight the vital importance of hand hygiene in preventing infections and strengthening infection prevention and control (IPC) practices. The WHO Framework for Action 2024-2030 emphasizes the importance of universal access to safe WASH and effective waste management as essential components of quality healthcare. It calls for integrating WASH and waste considerations into all aspects of health system planning, implementation, financing, and monitoring areas that can be strengthened through infection prevention and control (IPC) initiatives.

The theme for this year, "It might be gloves. It’s always hand hygiene," underscores the fundamental importance of hand hygiene as a key measure in protecting health, especially within healthcare environments, regardless of glove use. Hand hygiene is a crucial pillar of SDG 3, ensuring good health and well-being for all. By promoting universal access to clean water and sanitation (SDG 6), we protect communities from infections and strengthen global health resilience.

The Science Behind Hand Hygiene

Hands are the most common vector for pathogen transmission. Numerous studies confirm that hand hygiene is the single most effective practice to reduce the spread of infections, including healthcare-associated infections (HAIs), which affect millions of patients annually and contribute to antimicrobial resistance (AMR).

Key scientific facts:

• According to estimates by the Centers for Disease Control and Prevention (CDC), approximately 80% of common infectious illnesses are spread through hand contact.
• Proper hand hygiene can reduce diarrheal diseases by up to 40% and respiratory infections by 21% in the general population. (CDC)
• Effective hand hygiene disrupts the transmission of bacteria (e.g., MRSA, E. coli), viruses (e.g., influenza, norovirus, SARS-CoV-2), and fungal pathogens.

Global Situation and Gaps

Despite its proven efficacy, hand hygiene compliance remains low, especially in low- and middle-income countries (LMICs):

• Less than 40% of healthcare workers in LMICs adhere to recommended hand hygiene practices.
• More than one-third of healthcare facilities worldwide do not have sufficient handwashing stations available at the point of care.
• Many public and private healthcare facilities lack adequate water, sanitation, and hygiene (WASH) infrastructure.
• IPC breakdowns.

These gaps not only compromise patient safety but also facilitate the spread of emerging and re-emerging infectious diseases, such as COVID-19, Mpox, and multidrug-resistant pathogens.

It takes just 5 moments to change the world. Clean your hands, stop the spread of drug-resistant germs! To standardize and enhance compliance, WHO introduced the “5 Moments” approach, targeting:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After touching a patient
5. After touching the patient's surroundings

This framework provides a science-based, context-sensitive guide to minimize infection risk at critical points during care delivery.

Innovation and Behavioral Change

Recent advancements in promoting hand hygiene practiced in the COVID-19 pandemic globally include:

1. Alcohol-based hand Rub (60%) formulations are recommended by WHO.
2. Sensor-based hand hygiene monitoring systems in hospitals.
3. Behavioral change prompts and Communication material, such as visual cues and leadership modeling, significantly improve hand hygiene adherence.

AI & Generation Hand Hygiene Innovations

With AI adoption across the world, the healthcare industry has accelerated, through the introduction of exciting scientific Innovations that guide how we approach hand hygiene in the healthcare system:

• AI-Powered Hygiene Monitoring smart sensors, which improve compliance and infection control with real-time feedback.
• Advanced AI-driven sensor technology transforming healthcare environments.
• Sustainable, Waterless Hygiene Solutions
• With global water scarcity rising, waterless hand hygiene innovations, like biodegradable alcohol- based formulations and antimicrobial dry hand wipes
• UV-Based Hand Disinfection machines that kill bacteria and viruses
• Smart Dispensers & Internet of Things (IoT) Hygiene Compliance accessories track sanitization rates amongst healthcare personnel.

The Way Forward

• Policy Strengthening: National IPC guidelines should prioritize hand hygiene as a mandatory performance indicator.
• Infrastructure Investment: Ensuring continuous availability of ABHR, soap, and water at all healthcare and public facilities.
• Capacity Building: Regular IPC training and refresher courses for healthcare workers.
• Community Engagement: Public campaigns, especially in areas with maximum exposure like schools, malls, and transport hubs, to instill lifelong hand hygiene habits.
• Monitoring and Evaluation: Establish hand hygiene auditing systems at national and sub-national levels with clear benchmarks.

World Hand Hygiene Day goes beyond symbolic recognition. It serves as a call to implement evidence-based action. Clean hands save lives, reduce disease burden, and protect healthcare systems. In a world facing increasing biosecurity threats, hand hygiene remains our first line of defense. *Let’s commit together to clean care for all*

Written by ISID Emerging Leaders, Nadia Noreen (Medical Graduate, Public Health Specialist, and Epidemiologist with a  focus on international health regulations, global health security, disease surveillance, and health systems strengthening) & Nelisiwe Mhlabane (Epidemiologist, Research Manager, and Public Health Specialist)