Hand hygiene is a critical element in disease prevention, including preventing the spread of COVID-19, but based on the latest global estimates, 3 billion people lacked soap and water at home, 900 million children lacked soap and water at their school (of high importance when children return to school from closures), and 40% of health care facilities were not equipped to practice hand hygiene at points of care. Further, there are large inequalities between and within countries with some populations having severely low coverage of this basic service.