Budapest 2025: WHO and Europe Unite to Ensure Clean Water and Hygiene in Every Hospital

The "Meeting on Water, Sanitation and Hygiene (WASH) in Health-Care Facilities in the WHO European Region," held in Budapest in 2025, was organized by the WHO Regional Office for Europe in collaboration with Hungary's Ministry of Interior and its National Centre for Public Health and Pharmacy, with support from the WHO European Centre for Environment and Health in Bonn and the United Nations Economic Commission for Europe (UNECE). Experts and researchers from twelve nations, including institutions such as the University of Pécs, Semmelweis University, and the University of the Bundeswehr Munich, gathered to discuss how strong WASH systems can enhance patient care, infection control, and health-system resilience. They emphasized that WASH is central to universal health coverage and that every hospital's ability to provide safe, dignified care depends on clean water, proper sanitation, and effective waste management.

Turning Global Commitments into National Action

The meeting revealed that, despite long-standing international commitments, progress remains uneven across Europe. Only a minority of countries have secured sufficient funding or reliable data on WASH in their health-care systems. Hungary, which chaired the Protocol on Water and Health for 2023–2025, played a key role in linking political will with technical implementation. Country presentations showcased both progress and persistent inequities: Kazakhstan strengthened rural sanitation and hygiene infrastructure; Montenegro reformed its waste management systems after national assessments; Tajikistan launched a nationwide strategy aligned with SDG 6 following findings that only one percent of facilities offered basic WASH; and Turkmenistan upgraded over 300 medical institutions through new national standards. Despite the ongoing war, Ukraine continued to modernize its hygiene and energy systems, integrating accessibility measures for vulnerable populations. All participants underscored that sustainable WASH financing, reliable monitoring, and the inclusion of menstrual hygiene provisions are still pressing needs.

Integrating Health, Gender, and Climate Priorities

Discussions expanded WASH beyond its technical boundaries to its intersections with gender equity, labour safety, and climate change. Experts noted that poor sanitation and hygiene heighten risks of antimicrobial resistance (AMR) and healthcare-associated infections. The International Labour Organization's new standards on biological hazards, adopted in 2025, were cited as a milestone in protecting health workers through mandatory sanitary and water-safety provisions. The meeting also highlighted menstrual hygiene as both a gender and workplace equity issue, urging that health facilities ensure privacy, access to sanitary products, and stigma-free environments. On climate resilience, delegates presented models for green and adaptive health care. Germany's NOWATER project developed modular systems for emergency water supply during crises, while the Republic of Moldova's World Bank-backed initiative modernized rural clinics to reduce hazardous medical waste to under fifteen percent. At Hungary's University of Pécs, sustainability is now embedded in hospital operations through staff education, waste reduction, and water conservation.

Innovations in Risk-Based and Integrated Planning

The Budapest discussions emphasized that WASH must evolve from meeting basic standards to implementing continuous, risk-based management. Countries such as Italy, Serbia, and Hungary shared experiences with the Water and Sanitation for Health Facility Improvement Tool (WASH FIT) and water-safety plans. Italy's 2023 legislative decree made risk-based water-safety planning mandatory in all hospitals, requiring designated water managers and real-time monitoring via a national digital platform. Serbia's UNICEF-supported pilot projects focused on rural maternity hospitals and pediatric units, integrating flood preparedness into WASH planning. Hungary, an early adopter of water-safety planning for all public facilities, illustrated how integrated frameworks combining environmental health, air quality, and hygiene can enhance resilience. These examples underscore that a shift from compliance to prevention, supported by regulation, funding, and data systems, is key to protecting patients and health workers alike.

Education, Data, and Community as Drivers of Change

Scaling up WASH in health-care settings requires both top-down policy commitment and bottom-up engagement. WHO and UNECE introduced a new assessment tool to help countries evaluate existing conditions and plan improvements through practical checklists and guidance. At Semmelweis University, students participated in a "Hand Hygiene Competition" using scanning devices to evaluate cleanliness and build lasting habits. Meanwhile, medical students across Europe, through the International Federation of Medical Students' Associations, advocated for integrating climate and WASH topics into health curricula to better prepare future professionals. Delegates concluded that community participation is vital for sustaining progress, patients, residents, and frontline staff must all help monitor and maintain hygiene standards.

The Budapest meeting ended with a collective call to action: governments must embed WASH within health policy, establish SMART national targets, modernize infrastructure for sustainability, and invest in the training of all health personnel, from physicians to cleaners. As participants reaffirmed, safe water, sanitation, and hygiene are not optional amenities but the foundation of health security and human dignity. With renewed regional cooperation, the WHO European Region aims to ensure that every hospital and clinic becomes a model of cleanliness, resilience, and trust.