Hygiene & Behaviour Change Coalition

School children washing their hands at an outdoor fountain

The Hygiene and Behaviour Change Coalition (HBCC)

In response to the COVID-19 pandemic, Unilever and the UK Government’s Foreign, Commonwealth & Development Office (FCDO) joined forces to limit the spread of the virus in low- and middle-income countries. Between March 2020 and December 2021, this award-winning public-private partnership has reached more than 1.2 billion people with lifesaving behaviour-change messaging, hygiene products and access to training and education.

We share learnings to inform future responses to global health crises, including why handwashing is the simplest and most cost-effective way to avoid millions of preventable deaths.

Back in 1894, Unilever helped to improve hygiene with Lifebuoy soap during the cholera epidemic that was sweeping across Victorian England. 126 years later, Unilever is helping to stem the spread of the global COVID-19 pandemic with hygiene interventions. Through the Hygiene and Behaviour Change Coalition (HBCC) created by Unilever and the UK Government’s Foreign, Commonwealth & Development Office (FCDO), Unilever with its hygiene brands, including Lifebuoy and Domestos, have helped to reach over 1.2 billion people with hygiene behaviour programmes and awareness campaigns.

“Our business has a century-long history of promoting hygiene through our brands, but this unprecedented crisis called for an unprecedented response,” says Rebecca Marmot, Chief Sustainability Officer, Unilever.

Handwashing and hygiene: the backbone of the fight against COVID-19

Handwashing and hygiene are two of the most effective, affordable and easiest ways to help reduce the spread of germs. It was with the aim of helping as many people as possible adopt good hygiene habits that the FCDO and Unilever jointly launched the up to £100 million global partnership effort in March 2020.

Map marking 37 countries where the Hygiene and Behaviour Change Coalition had projects between March 2020 and December 2021 — Map of all 37 HBCC Countries: Afghanistan, Bangladesh, Brazil, Burkina Faso, Cameroon, Colombia, DRC, Ethiopia, Fiji, Ghana, Jordan, Kenya, Kiribati, India, Indonesia, Iraq, Pakistan, Papua New Guinea, Philippines, Myanmar, Mozambique, Nigeria, Nepal, Rwanda, Sierra Leone, Sri Lanka, Somalia, South Africa, South Sudan, Syria, Tanzania, Uganda, Venezuela, Vietnam, Yemen, Zambia, Zimbabwe

Since then, Unilever, with its expertise in hygiene behaviour change and mass media communications, has worked with 21 NGOs and UN partners via the multi-award winning HBCC partnership to implement on-ground programmes and run mass media campaigns, aimed at raising hygiene awareness and teaching hygiene principles.

Six smiling children in rural South Sudan showing off the Unilever soap bars they have been given to wash their hands — Credit: Save the Children / South Sudan

Unilever’s hygiene brands Domestos and Lifebuoy have a long history of hygiene programming. The HBCC projects have been established using these existing evidence-based programmes, benefiting from proven behaviour-change methodology.

HBCC hygiene campaign: Hands–Face–Space–Surface

Unilever also led the creation of a bespoke, global hygiene campaign for the coalition: The PASSWORD ‘Hands–Face–Space–Surface’ teaches and reminds people of the importance of key hygiene behaviours in the fight against COVID-19. It was translated into more than 30 languages, aired in over 18 countries and reached up to 200 million people. The campaign was offered to NGO partners to use for free, and they were supported by Unilever media experts on planning and airing of the campaign for best visibility and uptake.

Youth holding a poster of the ‘Hands–Face–Space–Surface’ password from the global hygiene campaign created for the coalition — Credit: WSUP

Through the HBCC initiatives, over 250,000 handwashing stations have been installed around the world and over 450,000 community health workers and teachers have been trained to deliver information on the importance of correct hygiene practice. More than 78 million Unilever hygiene products, including Domestos bleach and Lifebuoy soap and hand sanitiser, have also been donated and distributed in over 60 countries.

Reaching those most in need

The HBCC was designed to reach populations and communities whose living conditions increased their susceptibility to contracting Covid-19 and other infectious disease. NGO and UN partners were selected based on their experience and expertise in delivering programmes to vulnerable communities, like refugees.

Working with partners such as the UN Refugee Agency (UNHCR) and the International Rescue Committee (IRC) allowed the HBCC to establish specialist programmes that effectively supported people living through some of the world’s worst humanitarian crises, including in Cox’s Bazar in Bangladesh. Over 30 million Unilever hygiene products were donated to UNHCR for direct distribution to refugee communities.

The power of public–private collaboration

Of course, the huge scope and the quick deployment of the HBCC programme would not have been possible without the close collaboration of the public and private sectors. Unilever’s partnership with the FCDO, supported by academic experts in behaviour change and WASH (Water, Sanitation and Hygiene) at the London School of Hygiene & Tropical Medicine (LSHTM), represents the UK’s largest public–private partnership established to help slow the spread of the virus in vulnerable countries.

“Public–private partnership has been critical, allowing us to leverage the influence, expertise and networks of both government and business, and our strong network of NGO and UN partners, at home and overseas. We’re pleased to work together with partners to implement initiatives to address the pandemic at scale,” says Rebecca Marmot, Unilever’s Chief Sustainability Officer.

Aid worker wearing a mask giving boxes of Unilever hygiene products to a woman wearing a mask in Jordan — Credit: CARE International / Jordan

The HBCC continues

Experts agree that hygiene, alongside free and universal vaccination programmes, will continue to be of fundamental importance in the long-term response to COVID-19. Continued focus on hygiene is especially important where vaccines are not readily available. For countries that are eyeing post-pandemic life, maintaining focus on hygiene will be vital in helping people continue to live happy, healthy lives.

We know that there are large inequalities in access to hygiene and sanitation. Three in ten people do not have access to soap and water in their homes, and one in three healthcare facilities does not have access to hand hygiene where care is provided. It is our hope that one silver lining from this crisis may be recognition at a much greater scale of the vital role hygiene plays in health.

In early 2022, Unilever and the FCDO extended the HBCC in response to Omicron and other new COVID-19 variants. This second round of the HBCC is designed to support preparedness for future health-related crisis by strengthening local capacity. Working with ten UN and NGO partners across 18 countries the programme also combines measures to tackle COVID-19 vaccine hesitancy and encourage vaccine uptake where appropriate.

Mural showing the password for the campaing updated for HBCC2. It reads 'Hands Face Surface' and includes a vaccine reminder — The new PASSWORD Hands-Face-Surface (+vaccination) campaign mural

Three steps to keep UN SDG 6 on track

Together we can ensure that within 10 years, every single person on our planet can perform one of the simplest lifesaving acts, and that no child dies because of lack of access to water, sanitation and hygiene. We are asking the global community to take the following steps and achieve this crucial target.

Make and publish costed plans with clear deadlines: The adoption of costed national plans for water, sanitation and hygiene will ensure plans and finance go hand in hand. This will galvanise support and spur effective interventions.
Financial investment: Governments, donor agencies and local funding allocators must prioritise their investment in hand hygiene services and behaviour change around the world. NGOs must prioritise these activities, providing the expenses and support that will enable further investment, in particular to households, schools and healthcare settings.
Partnerships: More ground-breaking collaborations are urgently needed across the public and private sector, NGOs, academics and civil society organisations. By collaborating across sectors, we can pool our expertise and resources to great effect.