As nations around the world fight the coronavirus pandemic with mass lockdowns and travel bans, UN experts warn that some three billion people lack even the most basic weapons to protect themselves: soap and running water.
The outbreak has infected some 200,000 people and killed 9,000, scorching through populations across the globe after emerging in China late last year.
While Europe has become the centre of the battle against the virus, closing borders and sequestering millions of people in their homes, concerns are rising for developing nations with fragile healthcare systems. Countries across Africa and Asia have heavily restricted travel, imposed quarantines and closed schools, with fears for impoverished communities as infections begin to grow.
But one of the most fundamental practices individuals can adopt to shield themselves from COVID-19 - thorough hand washing - remains inaccessible for many millions.
Using household survey data, the United Nations Children's Fund estimates 40 percent of the world's population, or three billion people, do not have the means to wash their hands at home.
Sam Godfrey, UNICEF chief of water and sanitation in east and southern Africa, said communities lack easily accessible running water, are unable to buy soap or do not realise its vital role in preventing illness.
"Even for the frontline workers, the health workers, there remains a challenge also in terms of understanding of the importance of hand washing," he told AFP.
With the first infections in the region often coming from those who have travelled internationally, Godfrey described the outbreak as "almost like a rich man's disease for Africa, which, of course, will end up with the poor man suffering the most".
Those living in tightly-packed slums, as well as the large refugee populations in camps and urban areas in the Horn of Africa, are particularly at risk because they may be malnourished or have underlying health problems. And they often lack sanitation.
In sub-Saharan Africa, 63 percent of people in urban areas - 258 million people - lack access to hand washing, according to the UNICEF figures. In central and south Asia this figure is 22 percent, or 153 million people.
But at the Mathare slum in the Kenyan capital Nairobi on Thursday, people shrugged off the risk.
"Have you seen any of those people in hospital come from the slum? That is a disease for the rich," Ishmail Ayegah, a bicycle repairman, told AFP.
The World Health Organisation has sounded the alarm about the potentially devastating consequences of an outbreak that has pushed even wealthy nations to the limit.
"As the virus moves to low-income countries, we're deeply concerned about the impact it could have among populations with high HIV prevalence, or among malnourished children," chief Tedros Adhanom Ghebreyesus said.
Sharon Lewin, director of The Peter Doherty Institute for Infection and Immunity in Melbourne, told AFP the pandemic had highlighted "incredible discrepancies" in global health systems.
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