Thank you Neil for highlighting World Hand Hygiene Day 2026. If I had a dollar (or a pound) for the number of times I had heard people say that hand hygiene is a simple thing to crack or that it is a matter of common sense, I would be a rich person.
Sub-optimal adherence with recommended hand hygiene at specific critical moments by clinical healthcare workers is a behavioural problem and, as we have known for centuries, the timely action of hand hygiene is an intervention that halts microbial transmission and prevents healthcare-associated infection (HAI). It can therefore be considered to be a modifiable behavioural risk factor for the development of HAI. The most recent WHO/OECD Investment Case highlighted how, according to OECD analysis of 34 OECD and EU/EEA countries, enhancing environmental hygiene and hand hygiene in healthcare facilities generates the highest health and economic gains among 11 policy interventions against antimicrobial resistance (AMR). As a public health problem, HAI constitutes the most frequent adverse event in healthcare, and a report on the burden of disease attributed to HAI in 2011 found that, comparatively speaking, this exceeds the incidence of breast cancer and is comparable with the global burden of tuberculosis. Data for low- and middle-income countries was limited, but the disease burden is stated to be substantially higher. To mirror a phrase used by Prof Ali Mokdad and colleagues in a powerful paper from 2004, the absence of hand hygiene could be described as “a leading cause of death”.
WHO Guidelines on Hand Hygiene in Health Care make clear that modifying hand hygiene practices by healthcare workers is a complex task, influenced by many determinants. The importance of the interdependent influences of biology, environment, education and culture - as well as individual, institutional and community factors - when designing behavioural interventions is key. This is why improvement efforts must take a multimodal approach. Within this, access to trusted, reliable and actionable information is not peripheral but fundamental: it shapes knowledge, attitudes and risk perception, supports training and feedback, and underpins system-wide change. Without equitable access to high-quality information, other components of hand hygiene improvement such as infrastructure, supplies, and monitoring are unlikely to achieve their full impact.
World Hand Hygiene Day acts as a reminder each year for people to regroup and re-energise around this issue, and to promote hand hygiene as one fundamental part of a comprehensive infection prevention and patient safety programme. It is also an opportunity to reaffirm that improving hand hygiene depends not only on products and protocols, but on ensuring that healthcare workers everywhere have access to the reliable information they need to act at the right moment, every time, in the pursuit of quality healthcare outcomes.
Thanks again,
Jules Storr
Details of the papers/documents mentioned above:
The case for investment and action in infection prevention and control. Geneva: World Health Organization; 2025
Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D (2011) Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis.
The Lancet, 2011;377:228-41
Mokdad, AH, Marks, JS, Stroup, DF et al., (2004) Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291(10), 1238-1245.
HIFA profile: Jules Storr is CEO and co-founder of S3 Global Healthcare and past president of the Infection Prevention Society of the UK and Ireland. Her core subject matter expertise lies in infection prevention and control (IPC) which has been used as the foundation for developing strengths in strategy, leadership, behaviour change and implementation across diverse national and global programmes, including IPC, patient safety, quality health care, partnership working, water, sanitation and hygiene (WASH) and antimicrobial resistance. As a respected global healthcare leader and influencer Jules has a record of achievement in the development, implementation and evaluation of initiatives, guidelines and improvement resources in both high and low income countries. During the West Africa Ebola outbreak of 2014-15 Julie worked with colleagues in Sierra Leone to develop their national IPC programme. Previously, she led the award winning national cleanyourhands campaign, as assistant director of IPC at the English National Patient Safety Agency. She currently serves as an honorary advisor to Global Health Partnerships (formerly THET) and is on the steering group of HIFA and a member of HIFA Partnerships and Projects Working Group and Social Media Group. Jules is a champion of person-centred, compassionate care. Her recent work explores the social and behavioural dimensions of IPC, blending clinical expertise with human-centred care. Through her boutique consultancy she works as a consultant and adviser to a number of organisations including WHO, WaterAid and other development partners and charitable organisations. https://www.hifa.org/support/members/julie-0 email: julesstorr AT me.com