Hand hygiene evidence shapes global guidance In October 2025, BMJ Global Health published an open access supplement bringing together five systematic reviews on community hand hygiene. 14 The reviews examined behavioural drivers, intervention design, and the infrastructure and materials needed to support effective hand hygiene. Handwashing with soap and water can reduce diarrhoeal disease by around 30% and acute respiratory infections by approximately 17%. 15
Building the evidence base for global hand hygiene policy Supporting government action The underpinning systematic reviews identified 75 government measures that affect hand hygiene. 16 A practical resource for governments The supplement offers a single open access source that governments can use when developing or adapting hygiene standards. 17 Supporting policy uptake WHO is integrating the guidance into existing commitments across water, health and education, including through the European Protocol on Water and Health. 18 Direct influence on global policy The BMJ Global Health supplement formed the formal evidence base for WHO and Unicef’s first global Guidelines on Hand Hygiene in Community Settings Reframing hand hygiene as a system responsibility The evidence synthesised in the supplement supported a shift in how hand hygiene is understood by policymakers Enabling real world policy uptake WHO is actively using the BMJ Global Health evidence package in government facing policy processes
Together, the five systematic reviews published in BMJ Global Health formed the evidence base for the World Health Organization (WHO) and Unicef’s first Guidelines on Hand Hygiene in Community Settings.
Launched on Global Handwashing Day in 2025, the guidelines translate the evidence published in BMJ Global Health into actions that governments can adapt and implement worldwide. The guidelines provide a framework for policy, financing, regulation, monitoring and implementation, helping countries strengthen infection prevention and improve public health. “If anyone ever asks me within WHO if I have any suggestions for how to do things, BMJ Global Health will be my first recommendation.” Joanna Esteves Mills, Global public health consultant, World Health Organization, Geneva, Switzerland
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