Small steps for big change

Chair of the Global Hygiene Council Professor John Oxford discusses a new report into preventable infectious diseases in children worldwide


A recently published report commissioned by the Global Hygiene Council (GHC) highlighted that more than three million children under five years old will die from infectious diseases in 2017, and so proposed five steps to improve hygiene practices and reduce the burden of infectious diseases in children worldwide.

The ‘Small Steps for Big Change’ report highlighted this alarming burden, and the proposed five-step plan, which can be implemented by families, communities and healthcare professions, is designed to improve everyday hygiene practices and save children’s lives.

There has never been a greater focus on the health and wellbeing of children, yet every day, the health of the world’s children is under attack from common infectious diseases, which could be prevented through improved hygiene practices. According to Professor John Oxford, emeritus professor of virology at the University of London and chair of the GHC, “it is unacceptable that largely preventable infections such as diarrhoea are still one of the biggest killers of children globally.”

When *Portal asked Oxford about the main takeaways from the new report, he explained that its timing and content “are perfect, and it comes alongside the WHO Declaration Promoting World Health to 2030. The underlying principles of both documents is that, in a global perspective, good health is essential for sustainable development. The theme from WHO is Our Health, Our Future, Our choice. This economic look runs alongside our Small Steps for Big Change report, which may have a less grandiose title but does get to the point that children suffer from ill health, and that they are themselves key to their salvation through education.”

**H2 Mortality rates

The report states that more than three million children under the age of five die from infectious diseases each year, almost a million children die from pneumonia each year, and more than 700,000 children under the age of five die as a result of diarrhoea. The report also demonstrates the current complacency regarding hygiene practices, with over half of families (52%) not increasing surface disinfection at home during the cold and flu season, and that 31% of reported foodborne outbreaks occur in private homes.

Oxford explained: “Poor personal hygiene and home hygiene practices are widely recognised as the main causes of infection transmission for colds, influenza and diarrhoea. Handwashing with soap has been shown to reduce diarrhoeal deaths by 50%. By developing this five-step plan, we want to deliver a clear and consistent message about how small changes in hygiene practices could have a big impact on the health and wellbeing of children around the world.”

He told Portal: “We know from our GHC studies that very often women are key in the home to implement hygiene. Indeed, hygiene itself derives from the Greek Goddess Hygieia. It follows that home tuition to children on the concept and application will depend on women rather than men. In many developing countries where such practice needs to be improved, women are less empowered to act for cultural or religious reasons. However difficult this change may be and however many small steps of change will be required, nevertheless, we have a key issue to be solved. This would do no harm in our own country as well.”

**H2 Hand washing

The five-step plan has been developed by GHC experts, spanning paediatricians, infectious disease specialists, and public health experts from the UK, France, the USA, Nigeria and South Africa. The five-steps focus on making small changes such as improved hand hygiene and preventing the spread of infection-causing germs in the home and wider community. The potential big changes that might result include halving the incidence of diarrhoea and reducing the incidence and burden of common infections such as gastroenteritis, colds and influenza in babies and children.

Oxford said: “Families, communities and healthcare professionals need to acknowledge that improved hygiene is effectively a first line of defence, and that adopting better hygiene practices could have a dramatic and positive impact on the lives of young children worldwide.”

Child mortality has fallen by 50% in the past 20 years from 12 to just under six million. Asked by Portal how realistically can we expect this trend to continue into the next 20 years, Oxford said: “I am optimistic that child mortality can be pushed down further, and that the emphasis is on ‘pushing’. This goal will need effort otherwise the figures will creep up again. As more children survive into adulthood, parents will have fewer children; Charles Dickens had ten children and my grandparents had similarly large families. With smaller population increases, economic development can move forward, which, again, will further reduce early deaths.”

**H2 Support

With regard to the reduction of child mortality and how developing countries in particular might be better supported, Oxford added: “Developing countries will need infrastructure changes and economic help to ensure sustained improvement in the fight against child mortality. Of course, providing access to soap and clean running water to all children all over the world is fundamentally important to reducing the number of childhood deaths from largely preventable infectious diseases in developing nations.”

There is a sense that the campaign by the Global Hygiene Council also ties in to other public health issues such as the rise of antimicrobial resistance. While what Oxford then termed as the GHC’s “own special push towards ‘handwashing plus’”, in which the organisation is unique in its focus, for Oxford himself, “the findings set out in our Small Steps for Big Change report will, though, certainly aid the O’Neil report into antimicrobial resistance to come to fruition in the longstanding fight against drug resistant bacteria, most of which are spread faecal-orally”.

Professor John Oxford


Global Hygiene Council (GHC)

This article first appeared in issue 13 of Horizon 2020 Projects: Portal, which is now available here.