Water, Sanitation and Hygiene: Sustainable Development

Fleur Anderson Excerpts

Tuesday 17th October 2023 Westminster Hall

[Fleur Anderson (Putney) (Lab)]

It is a pleasure to serve under your chairship in this very important debate, Mrs Latham. I congratulate the hon. Member for Hendon (Dr Offord), my co-chair in the all-party parliamentary group for water, sanitation and hygiene, on securing this debate.

I declare an interest as co-chair of the all-party parliamentary group. I also spent seven years working for WaterAid before I became a Member of Parliament. That was not because it was the only job available to me at the time. I wanted to work for WaterAid, campaigning with people around the world for clean water, sanitation and hygiene, and deliberately did so because I had worked in development for many years before that and seen that WASH is fundamental to tackling poverty and achieving equality—to achieving what the British public want to see achieved from the support they give to international development. WASH and conflict are the two biggest issues that undermine progress in development.

As co-chair of the all-party parliamentary group, I am glad of this opportunity to talk about the global crisis, the rise of antimicrobial resistance, the impact on women and WASH at home and in the UK, and how investing in that will tackle poverty and inequality, and yield results far into the future. As previous contributors to the debate have said, 1.9 billion people live in severely water-scarce areas, and that number is growing all the time. It is a climate crisis. Also, 2.2 billion people do not have access to clean water and sanitation. That undermines our progress on so many of the sustainable development goals, and not only No. 6, which is dedicated to that issue, but those on climate, health, gender equality, food security, conflict and economic growth, so it is vital that we get this right.

The World Health Organisation has reported that two thirds of healthcare facilities in the world’s 46 least developed countries do not have access to hygiene facilities. Let us just pause to think about that. If my local hospital, St George’s, did not have water, it would be closed. It would not be open and would just not be seen as an acceptable place to offer healthcare. However, healthcare facilities around the world do not have water. That leads to a new-born baby dying every minute from infection caused directly by a lack of safe water and a clean environment.

Last week, I had the pleasure of becoming a grandmother. My granddaughter is in an incubator at the moment in a special care baby unit and it breaks my heart to think that she would not have access to hygiene. It is so important. We are terrified of that baby getting infected. Yet there are mothers around the world giving birth in places that are not hygienic and they do not have the healthcare facilities they need. It is not a matter of living in a hot country or one where it is difficult to access water. This is about political choice. Water can be provided to all those healthcare facilities and communities with the right amount of political will, support and focus.

In recent years, we have been on a steep decline in both investment and leadership on WASH. That is having a detrimental impact on the delivery of lifesaving basic services. Since 2018, UK aid for water and sanitation has been cut by two thirds and, shockingly, the total share of the aid budget going to water supply and sanitation was barely 1% in 2021. That does not tally, and as the hon. Member for Hendon said, there is a mismatch with what the UK public would like to see done with UK aid. They can understand that if a water supply is cut off, within hours and days people are absolutely desperate. They do not know what to do; their lives are turned upside down. The UK public understand how vital water is, but Government aid funding just does not seem to be in step with that.

Like others, I want to highlight the vital issue of antimicrobial resistance, which will be the leading cause of death in the UK by 2050, according to the Government’s own statistics. The current lack of water, sanitation and hygiene services in healthcare facilities increases infection, disease and death rates. The level of contamination means that antibiotics need to be used more often as a regular form of prenatal care in many countries and over longer periods of time, causing their effectiveness to be reduced in the long run. The World Bank has reported that if the current trend continues, antimicrobial resistance could push up to 28 million people into poverty by 2050, with global increases in healthcare costs predicted to range from $300 billion to more than $1 trillion by the same year.

The all-party parliamentary groups for water, sanitation and hygiene and the all-party parliamentary groups on antibiotics have produced a report on that subject called “Prevention first”. We took evidence from the World Health Organisation and from experts around the world about the need to curb the spread of antibiotic resistance. We found that a lack of hygiene means

“that doctors and nurses are unable to wash their hands before and after touching patients, new mothers are unable to clean themselves or their babies,”

and health workers are unable to clean as much as they would want to. Also, patients do not have a safe and hygienic toilet in their healthcare facilities. That causes repeated disease outbreaks that need to be treated with antibiotics, which contributes to the ever-increasing resistance.

Despite our inaction so far, there is a way to avoid this catastrophe—this ticking time bomb. Investing in WASH now, especially in low-resource nations, can go a long way towards containing the spread of antimicrobial resistance and save countless lives in the decades to come. It is such a good value-for-money investment and could be the huge step change that we need.

Another area is clearly gender equality. Women and girls have been said to be the priority for UK aid for many years now, under successive Ministers. Women make up 70% of the world’s healthcare workers and 90% of the world’s nurses, so the lack of WASH in healthcare facilities disproportionately impacts women, who are working in those facilities. Women face unique needs at times of pregnancy and childbirth; they need that clean and safe environment. Having access to WASH facilities prevents up to 1.4 million maternal and neonatal sepsis-related deaths each year—such preventable deaths, and such heartbreaking stories.

Equally distressing is the impact that the lack of WASH is having on women’s trust in healthcare. A White Ribbon Alliance survey of 1.2 million people from 114 countries found that women’s second highest priority was access to water, sanitation and hygiene. We have heard from previous contributors about the effect that this has on education. Walking to fetch water often takes away from time spent in schools. Having to care for sick relatives and family members takes time away from education, and I have met girls around the world who have to spend one week a month missing school when they are having their periods because they do not have toilets in their schools. That impacts on their education.

However, there are also good stories about WASH. I am constantly thinking about the women I have met in many towns and villages around the world whose lives were changed when they got access to water and sanitation. Their lives were changed; they became leaders in their communities; they were able to go out to work; their families were well and healthy. WASH can enable an enormous amount of women’s empowerment.

I want to be direct and tell anyone who may believe that this is an issue for other countries to worry about, and that it remains a problem of little consequence to the UK, that they are wrong. Unless we invest in WASH abroad, we will see a significant, prolonged and costly impact here at home. The most resistant infections treated by the NHS originated elsewhere in the world. Healthcare-acquired infections already cost the NHS at least £2.1 billion a year, and that will go up as infections become increasingly resistant to antibiotics. So while I am delighted to have the Minister here, we really need a Health Minister here, to accept the impact that this will on the NHS here.

To conclude, I was pleased to learn from the Minister for development, the right hon. Member for Sutton Coldfield (Mr Mitchell), that FCDO officials worked hard to lobby for the inclusion of water, sanitation and hygiene language in the political declarations at the recent UN high-level meetings on universal health coverage and pandemic preparedness and response. We also had several meetings with the Minister in advance of those meetings. But it was disappointing not to see the vital importance of WASH reach the messaging in UK Ministers’ speeches and press releases. They are constantly saying that WASH is a priority, but that does not come out at the highest level at the moment it is needed.

Can the Minister ensure support for WASH at the most senior level and ensure that these undervalued issues are given the political priority they deserve at future international events? Given that WASH is a top priority for MPs and the public, and is so clearly in Britain’s own best interests, will he commit to prioritising investment in water, sanitation and hygiene services across the developing world, and to say, “What about WASH?” in all development projects?

How do the Government plan to increase the prominence of antimicrobial prevention measures in any future WASH investments? Will the Foreign, Commonwealth and Development Office be restoring UK official development assistance funding for WASH—which has fallen by two thirds between 2018 and 2021—as part of its women and girls strategy? I thank hon. Members very much for this debate, and I look forward to the Minister’s responses.