On Global Handwashing Day, WHO and UNICEF released the first-ever Global Guidelines on Hand Hygiene in Community Settings, offering evidence-based recommendations for homes, schools, and public spaces. These guidelines aim to help governments and practitioners promote effective hand hygiene outside healthcare facilities, framing it as a public good and a government responsibility. By translating evidence into practical, ready-to-adopt actions, the guidelines support sustainable access to hygiene services, which can reduce diarrhoeal diseases, acute respiratory infections, and other preventable illnesses, while strengthening routine public health and emergency preparedness, including cholera outbreaks.
Despite clear benefits, in 2024, 1.7 billion people still lacked basic hand hygiene services at home, including 611 million with no facilities at all. Achieving the 2030 target will require accelerated global progress—doubling the current rate, with up to 11-fold increases in least-developed countries and 8-fold in fragile contexts. Hand hygiene remains one of the most cost-effective public health interventions, cutting diarrhoea by 30% and acute respiratory infections by 17%, with significant population health gains.
The guideline recommendations are:
Hand hygiene in community settings is an important public health measure; governments should promote it by removing barriers and enabling sustained behaviour change. This includes clear roles, financing and monitoring at national and local levels, consistent with international health obligations.
Hand hygiene should be practiced using plain soap and water long enough to fully cover and rub both hands; when hands are not visibly dirty, alcohol-based hand rub (≥60% alcohol) is an effective alternative. Five key times are emphasized: before preparing food; before eating or feeding/breastfeeding others; after using the toilet or handling faeces; after coughing/sneezing/nose-blowing; and when hands are visibly dirty.
Core requirements include: (a) Minimum materials on premises – reliable water plus soap or alcohol-based hand rub (ABHR) – with safe grey water disposal; (b) clear information on why, when, how and where to clean hands; and (c) a conducive physical and social environment so facilities are convenient, accessible and easy to use, and norms support regular practice.
The guidelines also outline seven cross-cutting principles for implementation: prioritize material needs, understand behavior drivers and barriers, engage communities, ensure gender responsiveness, commit to progressive improvement, strengthen systems, and monitor and evaluate progress.
WHO and UNICEF emphasize that hand hygiene efforts must move beyond short-term projects and become part of sustained, government-led national and local systems. While governments and international agencies often respond rapidly during disease outbreaks, momentum is usually lost after emergencies end, leaving systems vulnerable. Breaking this cycle requires strengthening policies, legal frameworks, regulation, monitoring, and coordination through national institutions with adequate human and financial resources.
Such measures ensure the equitable, sustainable delivery of hand hygiene services, including accessible and affordable facilities, their operation and maintenance, and ongoing behavior-change strategies—ultimately safeguarding public health in everyday life and during crises.