Japan is demonstrating its leadership in global health this week by co-hosting a Universal Health Coverage Forum of international leaders and policy-makers, part of the drive to ensure health coverage for all by 2030.

With Japan’s own story of rebuilding into today’s prosperous and forward-thinking society, with effective provisions to ensure health care for all, its leaders are well placed to assume a leading role in the Universal Health Coverage movement, which aims to ensure pandemic preparedness and better health for all through strengthened health systems.

As the forum--co-hosted by the World Bank, World Health Organization, Universal Health Care (UHC) 2030 and UNICEF--convenes, WaterAid is calling on governments and donors to act in recognition that this goal cannot be achieved without investing in clean water, sanitation and good hygiene in all health facilities, everywhere.

In a modern and technologically advanced city like Tokyo, it is difficult to imagine there are parts of the world in which health-care facilities are operating without water. But 38 percent of health-care facilities in the developing world, and 42 percent in Sub-Saharan Africa, do not have access to a source of clean water, with devastating impact for patients, health professionals and communities.

What this means is doctors, nurses and midwives delivering babies and treating patients for critical illnesses without being able to wash their hands or properly sterilize implements. It means laboring mothers bringing their own water--often drawn from rivers or ponds--to hospitals in heavy, 20-liter jerrycans so that the nurses can clean the delivery room, and their families scrubbing hospital sheets themselves in buckets of dirty soapy water.

Infection prevention and control is almost impossible in the absence of clean water, decent sanitation and good hygiene. It’s also more difficult to prevent disease, as well as to ensure a good recovery afterward. Diarrhea, cholera, pneumonia, undernutrition, parasites and blinding trachoma all have links to drinking water, hands, soil and food contaminated with human feces.

In any pandemic--whether it be SARS or Ebola--infection control is critically dependent on rigorous hygiene control, along with clean water and good sanitation. Antimicrobial resistance takes stronger hold when soap and water isn’t available for proper cleaning, leaving doctors and nurses to prescribe antibiotics to prevent infections instead.

Japan is a world leader in aid for water, sanitation and hygiene, as well as on health. More than any other nation, its leaders understand that water, sanitation and hygiene are excellent values for the money, delivering a $4 (454 yen) return in improved productivity on every $1 spent and ensuring healthier, more prosperous communities and countries.

This is particularly true in health care, where WaterAid’s work has shown us that incorporating water, sanitation and hygiene makes other aid efforts more effective. More babies survive when hospital staff are not only trained in medical techniques but also given the resources and training in proper infection control procedures. Fewer children fall ill with diarrhea when communities receive clean water supply points, good latrines and hygiene promotion, particularly when their parents are taught proper hygiene for food handling and storage, and when and how their children should properly wash their hands with soap.

This week’s Universal Health Care Forum will review progress on universal health coverage at global, regional and country levels. Water, sanitation and hygiene must be a core part of this agenda, through an integrated approach that looks beyond infrastructure to strong monitoring and accountability, improved management and operation of services, improved training for hygiene and cleaning, improved regulatory and accreditation systems and adequate financing.

We look to the government of Japan, as hosts and leading donors, to champion the need for integrated investments including water, sanitation and hygiene, to deliver quality health care for all.

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This article was contributed by Tim Wainwright, chief executive of WaterAid, and Kaoru Takahashi, WaterAid representative in Japan. WaterAid is an international organization whose mission is to transform the lives of the poorest and most marginalized people by improving access to clean water, sanitation and hygiene.