A good skier knows, in a slalom race, to pass through a gate, you must think ahead about preparing for the next gate. And it is true for everything: the best way to deal with a crisis is to act and be prepared to learn from it in order to manage the next crisis as best as possible. It may seem a bit counterintuitive: and yet, if we had, in all circumstances, taken heed of what we had learned from the previous crises, the one we are going through today would have been much easier to manage.
There are many lessons to be learned, starting today, from the current crisis, in order to better overcome it and better prepare for the inevitable next one. Firstly, on the allocation of resources for each national health system, with respect to staffing and equipment; then on the terms of international coordination, and in particular the more or less coercive measures that the World Health Organization (WHO) must have at its disposal: it makes no sense that the WHO has much less power than the International Olympic Committee (IOC) or the Fédération Internationale de Football Association (FIFA) in their respective fields.
There is an additional sector in which rapid action is required during the current crisis, which is relevant for the present and future, and that is hygiene. We must not forget that the current crisis started because of a hygiene problem in a wholesale food market in Wuhan.
It is an opportunity to remember that hygiene is a major economic, social, cultural and political issue. And that it is urgent to treat it as such. And to act massively. Immediately.
More than 45% of the world’s population does not have access to effective hygiene services; and more than 40% of the world’s population lacks basic handwashing facilities at home. More than 2 billion people do not have access to toilets. More than half of the world’s population acquires their food from wholesale markets with poor hygiene. At least 10% of the world’s population eats food that is irrigated by wastewater. And you do not have to go very far to see how little attention has been devoted everywhere to urban hygiene, personal hygiene and hygiene at work; the current electoral campaign in France should serve as an opportunity to remember this.
The impact of hygiene on our health is long settled: lack of handwashing contributes to more than 40% of diarrhoea rates and 23% of respiratory infections. Countries with poor hygiene have the highest levels of under-five mortality rate, malnutrition, and poverty. Lack of hygiene in offices and factories also reduces productivity, and as a result, economic growth as well. Lack of hygiene is a reason for not using public transportation, not going to a restaurant, and not entering a shop or cinema. Particularly, a study conducted in Bangladesh showed that 73% of female workers miss six days of work per month because of the lack of hygiene facilities and services dedicated to women.
This issue does not only concern the developing countries: the richest countries, which have the means for hygiene-related services and facilities, have not fully addressed the issue. In particular, a study showed in 2014 that the lack of hygiene costs 14.5 billion in France, 13.7 billion in Great Britain and 12.6 billion in Germany.
It would therefore be particularly profitable, here and now, to invest in the sectors of the economy that relate to hygiene. And it would be very profitable, even in the most basic sector: A 2012 WHO study showed that every euro invested in the hygiene sector brings a return of 5 euros (by reducing the number of premature deaths, slashing health care costs and increasing productivity). A UNICEF study in China showed that distributing soap in primary schools would reduce the rate of student absenteeism by half.
As we prepare, everywhere, to put in place policies to boost supply and demand, it would be good to think about this issue too: a major global hygiene development policy should involve not only the infrastructure sectors (such as wastewater networks, wholesale markets, etc.) but also companies producing hygiene-related products, recycling these products, which today are too often made of single-use plastic. It is therefore understandable that there is a very close relationship between hygiene and environmental protection. Both of these issues lead us toward related actions and behaviours. With incalculable consequences: hygiene is an essential factor that affects trust. And in the current situation, nothing is more important than restoring trust.