Wednesday, July 22, 2009

This Benevolent Hand Gives you Soap: Reflections on Global Handwashing Day from an International Perspective

This blog is a summary of This Benevolent Hand Gives you Soap: Reflections on Global Handwashing Day from an International Perspective by Anna Plyushteva published in December 2008 and available at Kumi Naidoo, Honorary President of CIVICUS commented on this initiative on the CGO homepage.

What is your take?

Global Handwashing Day first took place on October 15, 2008, with the aim of promoting handwashing with soap as a key strategy to reduce child mortality and improve health among the poor, under the slogan of “Clean Hands Save Lives”. Global Handwashing Day is to become an annual event similar to World AIDS Day and is part of an ambitious strategy to reduce diarrheal incidence by 47% and save at least one million lives through the promotion of washing hands with soap.

While BBC News referred to this as “UN Handwashing Day”, the organisation behind Global Handwashing Day is in fact the Public-Private Partnership for Handwashing with Soap (PPPHW 2008a), which includes the World Bank, USAID, the London School of Hygiene and Tropical Medicine, UNICEF, as well as the world’s three biggest soap manufacturers: Colgate-Palmolive, Unilever and Procter & Gamble.

The founding document of this PPP, “Sanitation and Hygiene: Unleashing the Power of the Market,” states the four objectives for the founding of the PPPHW, one of which is “to understand the existing global market for soap, as well as the constraints and opportunities for market expansion to the poor through PPP” (PPPHW 2000:3). What was once an exclusive public health issue became framed as an opportunity ripe for private sector involvement.

Why would multinational corporations take an interest in health-through-handwashing? Faced with market saturation, intense competition and stagnant sales growth in developed countries, the three soap manufacturers who are part of the PPPHW programme perceive this initiative as a strategic market development opportunity in largely untapped low-income markets.

While a popular example of private sector engagement with the ‘base of the economic pyramid’, PPPHW sparked immediate criticism. For example, some asked why tax-cut incentives to make soap more affordable were not at all considered by the PPPHW as a possible strategy for achieving its goal of persuading the poor to buy more soap, despite considerable success with this approach in India. Indeed, this would have necessitated government involvement; yet governments were not included as partners in the project.

The Global Resistance group, an alliance of activists opposed to corporate globalisation, is one of many which criticised the “Health in your Hands” initiative in Kerala, India highlighting the fact that the claims to good intentions of the promotion of hand-washing with soap are not enough, as they occur in a context of lack of access to drinking water, water shortages and lack of piped water supplies to poor communities, resulting in the poor buying severely over-priced water from water tanks. This analysis claims that of the two ingredients needed for washing one’s hands with soap – water and soap – it is access to the former, rather than willingness to use the latter, that is the real issue. Moreover, despite the recent developments in the manufacturing of waterless handwashing solutions, such technologies are not part of the Global Handwashing strategy or rhetoric, leaving a profound roadblock unaddressed.

Reports from Kerala have not only highlighted the outrage of local people regarding their portrayal as dirty and hygiene-ignorant, but have also pointed to the local informal market for soap. An alternative approach to the promotion of soap usage, such as the reduction of tax on soap described above, would have boosted the revenue of local enterprises.

This project, according to the critique, depicts the problematic behaviour of “the poor” as the root cause for inadequate hand-washing practices. The author argues that the lack of use of soap cannot be reduced to uninformed and unreasonable behaviour on behalf of low-income individuals. The lack of comprehensive provision of affordable piped water and sewage to poor communities – a structural issue – seems to be a much more fundamental reason for poor hand hygiene.

Lastly, the expert discourse of the Partnership leaves little space for the voicing of critical opinions from the supposed beneficiaries. A search on the first 100 results returned by the search engine at on November 15, 2008, on the search terms “global handwashing day” were statistically rich, uncritical and, without exception, supportive of the Global Handwashing initiative.