Ways to step up the fight against global antimicrobial resistance | Letters

Decision-makers must acknowledge the pivotal role that water, sanitation and hygiene play in preventing infection, writes WaterAid's Margaret Batty. Meanwhile Matt Ball of the The Good Food Institute says moving to plant-based and clean meat is the best thing we can do to avoid pandemics of antibiotic-resistant superbugs

With drug-resistant infections now causing the deaths of half a million people a year, access to clean water and decent sanitation has never been more vital in the race to prevent a global antimicrobial resistance catastrophe. As Dame Sally Davies poignantly highlighted in your report (Experts issue new warning on overuse of antibiotics, 27 March), "the importance of clean water, sanitation and vaccination must not be forgotten to avoid infections occurring in the first place". This point, alongside the critical role of hygiene, is absolutely key.

This is already a global health emergency, with 844 million people lacking access to clean water and 2.3 billion without safe, private toilets. In developing nations almost 40% of healthcare facilities do not have a water supply, 19% do not provide adequate sanitation and 35% do not have soap and water to sustain good hygiene practices. Without these basics in place, infection prevention and control in healthcare settings becomes almost impossible. So it is no surprise that hospital-acquired infections are the third major driver of antimicrobial resistance globally.

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