Expand safe water, sanitation and hygiene to reduce infections and antibiotic demand

Governments and service providers should expand safely managed water and sanitation, handwashing facilities, fecal-sludge management and reliable hygiene services in communities and healthcare facilities. These measures reduce exposure to enteric and other pathogens, lower infection incidence and reduce antibiotic demand.

Infrastructure must include long-term operation, maintenance, water quality monitoring and equitable access. Evidence directly linking WASH programmes to resistance outcomes is still limited, so programmes should measure infections, antibiotic consumption and environmental resistance alongside service delivery.