Health & hygiene

Although adequate access to WASH is a basic human right, the number of people who suffer from poor or lack of access remains staggering: 2.3 billion people lack access to safely managed water services, and nearly 900 million people defecate in the open; 4.5 billion people lack safely managed sanitation; 1.4 billion people lacking basic handwashing facilities with soap and water at home; and 844 million people lack access to safe drinking water.

The World Health Organization estimates that tackling these interconnected issues has the potential to prevent at least 9% of global disease, and 6% of all deaths. Evidence shows that people will be healthier and happier and communities will be more productive if they have improved access to sanitation, safe drinking water, and basic levels of hygiene. Tackling these issues is essential to lifting people out of poverty.

Our health and hygiene brands – Lifebuoy, Domestos, Smile, Pureit and Vaseline – aim to improve health through better hygiene. These everyday products – soaps, toilet cleaners and toothpastes – as well as our innovative water purifiers, can help prevent disease and improve people’s health and well-being. And ultimately, help to save lives.

But health is not just about hygiene. Many people worldwide suffer from low self-esteem and feel anxious about their bodies. And this can have a knock-on effect on their personal lives and careers. Through Dove, our leading Beauty & Personal Care brand, we’re helping women and girls to be confident in their own bodies and build their self-esteem.

The health and hygiene pillar of our Unilever Sustainable Living Plan (USLP) primarily contributes to two of the UN Sustainable Development Goals (SDGs): Good Health and Well-being (SDG3); and Clean Water and Sanitation (SDG6).

Addressing social challenges is good for society and good for business. Many of our programmes drive growth directly – our oral care, handwashing and sanitation programmes are strong examples. When more people brush their teeth, use soap regularly and have access to sanitation, their use of toothpaste, soap and toilet cleaner increases. Domestos is helping to give people access to improved sanitation which drives market development for our business.

We run many of our health and hygiene initiatives through brands in our Beauty & Personal Care (BPC) division. BPC is our largest division with a €21.9 billion turnover in 2019, and it accounts for 42% of our turnover and 52% of our operating profit. It is home to brands such as Dove, Signal and Lifebuoy. Lifebuoy is the world’s number one antibacterial soap brand.¹

Our Home Care division generated turnover of €10.8 billion in 2019, accounting for 21% of our turnover. It includes our water purifiers Pureit and Truliva (formerly Qinyuan) as well as Domestos, our market-leading toilet cleaning brand, which is helping people to gain better access to toilets.

Providing quality, affordable products is only part of the solution to improve health through hygiene. Products alone are not enough. A big part of our work is encouraging people to adopt healthy habits. Studies show that most people know they should brush their teeth twice a day, wash their hands with soap after going to the toilet and before eating, but often they don't.

As one of the world's leading consumer goods companies, making products that people use every day, we understand the triggers, barriers and motivators that generate sustained behaviour shifts. Underpinning our approach is our behaviour change model, the Five Levers for Change (PDF | 4MB). This is a set of principles that, when applied consistently, increases the likelihood of creating a lasting impact. We use this knowledge, coupled with our expertise in marketing and in delivering campaigns at mass scale, to catalyse enduring change in everyday behaviours.

Lifebuoy runs one of the world's largest handwashing programmes. In order to reach our 1 billion target, we set about finding ways to deliver effective handwashing behaviour change at an even lower cost. We have long believed that the totality of our marketing efforts is contributing to changing handwashing behaviour, including mass scale TV advertising.

So, to test this, we ran a study (a randomised control trial) in India, our biggest market, to assess the effectiveness of Lifebuoy TV adverts and found positive results. The study was published by the Journal of Health Communication and we included Lifebuoy TV reach in our Health & Well-being performance figures for the first time in 2018 alongside our on-ground programme reach. Through TV reach, we successfully achieved our Health & Well-being target of reaching over 1 billion people – two years ahead of schedule.

Research shows that media can be a powerful source of influence on young people’s perception of body image and emotional intelligence. Recognising this, Dove is working in partnership with the Cartoon Network to help young people with their body confidence through cartoons. Steven Universe, the critically acclaimed cartoon series is recognised for its themes of inclusivity, empathy and relatability. The show’s diverse characters fight evil by getting strength from their body type, matching the Dove Self-Esteem Project’s commitment to building body confidence and self-esteem in young people.

All content was co-created with body image expert Dr Phillippa Diedrichs from the University of the West of England’s Centre for Appearance Research. Grounded in scientific evidence, our priority was to make content that would have a meaningful impact on young people’s self-esteem. We’ve created a series of short episodes on issues that matter to children, like teasing and bullying, appreciating our bodies, and navigating social media. By the end of 2019, we had reached over 21 million through the Cartoon Network in a Steven Universe series.

And our oral care brands – Signal, AIM, Mentadent, Pepsodent, Prodent and P/S – are reaching children and mothers through a series of TV adverts, as part of Smile’s (our oral care masterbrand) ongoing Brush Day & Night campaign.

We’re using our expertise to come up with innovative products that can help more people live healthier lives.

For example, our water purifiers offer water that is not only safe and convenient to use, but that tastes good too. We now offer a range of water purification solutions across three technologies: gravity, UV (ultraviolet water purification, which disinfects bacteria from water) and RO (reverse osmosis, a water treatment process that removes contaminants by using pressure to force water molecules through a semi-permeable membrane, which filters out the contaminants).

In 2019, we introduced our Pureit Copper+ RO model. Copper is an essential mineral for human health. It has anti-microbial and anti-inflammatory properties and also helps to neutralise toxins. Our Pureit Copper+ RO model uses smart Copper Charge Technology™ to ensure the right amount of copper in every glass of water.

We have developed new low-cost products, such as our Domex (Domestos in India) Toilet Cleaning Powder, for people in rural areas who may never have had a toilet at home before. Our Domex Toilet Cleaning Powder removes all germs at an affordable price and it also keeps toilets smelling fresh.

In July 2010, through Resolution 64/292, the UN General Assembly explicitly recognised the human right to water and sanitation. It acknowledged that safe and clean drinking water and sanitation are essential to full enjoyment of life and all human rights. We respect these rights by ensuring that we operate our business in a way that fulfils the human right to water, as defined by the UN Human Right to Water Policy. We’ve also signed the World Business Council for Sustainable Development WASH Pledge to ensure access to Water, Sanitation and Hygiene (WASH) in all our factories, plantations and workplaces.

Heads of state from all around the world gathered in New York in September 2015 to adopt the 2030 Agenda for Sustainable Development, resulting in 17 Sustainable Development Goals (SDGs). SDG6 focuses purely on water and sanitation, aiming to “ensure availability and sustainable management of water and sanitation for all.” We worked with others to call for hygiene to be included as a key component within this SDG and welcomed the inclusion of indicators measuring access to handwashing with soap facilities.

Through our brands, behaviour change programmes and by joining forces with others around events – such as the UN General Assembly, Regional Water, Sanitation and Hygiene summits, World Handwashing Day and World Toilet Day – with our partners, we’re contributing towards achieving SDG6.

Partnering with organisations who share our ambition to improve health through better hygiene is critical to our programmes achieving a positive impact on a large scale. We work with partners in many ways, including: joint advocacy programmes to raise the profile of issues; scaling-up existing programmes; piloting initiatives; and securing additional funding to increase the impact of our joint investment.

Businesses are well-placed to work with governments, civil society and development agencies to drive transformational change. Whether it’s through our understanding of consumers, knowledge of behaviour change, the design of innovative products, our ability to deliver programmes at mass scale or the provision of financing, we bring a host of resources and knowledge to the table that can strengthen our collaborations. And in turn, improve people’s health and well-being while simultaneously growing our business.

Catalysing interested groups to come together around a shared objective is something we have found particularly useful. The Toilet Board Coalition is one example which Unilever was a founding member of – a global, business-led alliance of companies, investors, sanitation experts and non-profit organisations, which aims to develop sustainable and scalable solutions to the sanitation crisis.

By 2020, we will help more than a billion people take action to improve their health and hygiene. This will help reduce the incidence of life-threatening diseases like diarrhoea – one of the biggest causes of deaths in children under five.

We achieved our target by the end of 2018, two years ahead of schedule.

By the end of 2019 we had reached over 1.3 billion people, over 615 million of whom were reached through on-ground programmes and over 710 million through TV reach on handwashing, oral health and self-esteem: 1.07 billion people with Lifebuoy (486 million people through on-ground programmes and 587 million through TV reach)²; over 28 million with improved access to a toilet^{3 & 4}; over 102 million through our oral care brands; over 60 million through Dove self-esteem programmes; over 5 million through Vaseline’s Healing Project and 55 million with safe drinking water from Pureit.

Pureit also provided 114 billion litres of safe drinking water by the end of 2019.

Nine years into our Unilever Sustainable Living Plan (USLP), we’ve learnt that it’s possible to reach people at scale. But to scale our programmes effectively and reach as many people as possible, we need to work in partnership.

Having surpassed its USLP target, Dove has a new ambition: to have helped a quarter of a billion young people improve their self-esteem by 2030. To achieve this ambitious target, Dove is developing a number of approaches to reach even more young people. For example, in 2019, we announced a new three-year partnership between Dove and UNICEF to help 10 million more young people gain self-esteem and body confidence through new educational modules for 10-18 year-olds in Brazil, India and Indonesia.

Dove is also reaching young people through its partnerships with the Cartoon Network on a Steven Universe series, and the US media company ATTN in the creation of ‘Girls Room’, a new five-episode scripted US series from Emmy-award winning writer, producer and actor Lena Waithe. ‘Girls Room’ tackles the pain and power of female adolescence through the eyes of five girls as they face the challenges of growing up in today’s social media world.

Over 700 children under the age of five die from a sanitation-related disease every single day, but to tackle sanitation issues, we must collaborate and combine a range of expertise to bring about the change at scale that is so desperately needed.

Systemic change can only be achieved in partnership with governments. In 2019, we began working with GIZ (the German development agency), as well as the Philippines’ government, to drive the Domestos’ Cleaner Toilets, Brighter Futures programme across the country and identify improvements to the model, so that once toilets in schools are clean and usable, they can be kept that way.

Domestos is focusing its efforts on engaging and partnering with local authorities and education boards around the world. We know the ‘cure’ to stop thousands of people dying from poor sanitation every year. We now need to work together at scale to ensure that everyone has access to it. As UN Water notes, a toilet is not just a toilet, it’s an opportunity-maker, a dignity-provider, a lifesaver. Together, we all need to prioritise SDG 6 – and help make it a reality, not just a goal.

¹ Unilever calculation based on Nielsen volume sales information for the total markets (latest 12 months). Updated August 2019.

² The evidence that TV drives handwashing behaviour change comes from a proof of principles study in India.

³ Results are reported by UNICEF in accordance with its methodology and includes reach from direct and indirect initiatives over 2012-2019; and also includes Clean Toilets, Brighter Futures reach of over 70,000 children by the end of 2019.

⁴ The Domestos reach reported in our Annual Report & Accounts 2019 was under-reported and should say “Domestos has built on its partnership with UNICEF, which helped more than 28 million people (between 2012 and 2019) access better sanitation and hygiene”.