Infections respect no boundaries, which is why the World Health Organisation (WHO) is taking  global action on healthcare associated infections.

Professor Didier Pittet, director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, says: “Every year healthcare associated infections [HAI] affect hundreds of millions of patients globally. Effective hand hygiene by healthcare workers can reduce the toll.

“In the decade since the WHO has run its Clean Care is Safer Care campaign to promote better hand hygiene, compliance by healthcare workers has increased from 20-30 per cent to 80 per cent. Analysis shows that the WHO's multi-modal strategy could reduce all infections of hospital patients worldwide by up to 80 per cent and save up to eight million lives a year.”

The campaign is now active in 183 countries and the WHO offers over 50 tools to help. “The most important is the Five Moments for Hand Hygiene tool that sets out five points at which hand hygiene protects patients, health workers and the community from the spread of infection,” says Pittet.

But in order to minimise 'message fatigue' novel ways are used to convey the importance of effective hand cleaning. Every May 5th the WHO's Save Lives: Clean Your Hands campaign promotes hand hygiene activities.

“In 2009 we launched a hand hygiene dance with moves showing the most efficient way of using alcohol hand rub,” says Pittet. “Adaption helps adoption so the dance has been adapted to suit different cultures and musical tastes - but the hand rub application gestures remain the same.”

The adaptation strategy also applies to hand rub solution. “In Mali imported alcohol rub was too expensive, so we supported its local preparation from sugar cane. It can also be made from rice, maize and walnuts and now 50 countries make their own,” says Pittet.

Another important tool is the WHO's 500-point scoring system which allows healthcare institutions to monitor and improve their practices. The best performers earn hand hygiene excellence awards and are encouraged to help other institutions. A winning hospital in Hong Kong devised a hand hygiene relay in which 266 health workers used alcohol hand rub in turn, setting a world record. In 2015 over 30,000 people took part in relays internationally and an Iranian hospital set a new record with 660 workers.

Last year saw the launch of a social media campaign in which workers took 'selfies' while holding a board saying ‘#safe hands’. In three months over 60 million people participated

“This May 5, we are launching the Safe Surgical Hands campaign. Around 313 million people have surgery worldwide annually and in some countries up to a third get surgery-related infections,” says Pittet. “Improved hand and general hygiene in operating theatres, recovery rooms and wards could reduce this.”