He deliberately created and promoted an easy-to-make, patent-free formula which has replaced soap and water in hospitals worldwide.
In the 1990s, Didier Pittet, an infectious diseases specialist at Geneva University Hospitals, wanted a fast way to disinfect hands – in hospitals, workers might need to do it up to 20 times an hour. He worked with a colleague, British pharmacist William Griffiths, to develop today’s hand sanitiser gel.
Prof Pittet said early versions of “alcohol-based hand rub” were a liquid “rinse”. He said: “There were rinses made in Germany, but not used very much. William was interested in them but they had never been advertised and it was not clear what to use them for. We wanted a product specifically for skin, and if you are going to use a water and alcohol product on the hands, you need to add emollient, an agent that protects your hands. Finally, we found the right combination, with 75% alcohol. Originally, we used a sophisticated, costly emollient. Looking for a cheap accessible solution, we replaced it with glycerin. You can’t patent glycerin, or alcohol or water, so we could produce a patent-free product.”
The new hand-hygiene strategy
He added: “Once we demonstrated in Geneva we could reduce infections and save lives, we thought the impact would be even larger in developing countries. We published a 2000 paper in The Lancet which is one of the most read ever. Hundreds of hospitals visited us.” They promoted use of the rub and explained a complete hand-hygiene strategy for hospitals, and in 2005 the WHO asked them to do the same globally.
The Clean Care is Safer Care programme now operates in 189 out of 195 UN states. Prof Pittet travelled to meet health ministers, explaining how they could make the rub using locally available products. This year, Covid-19 led to shortages all over the world, he said, which encouraged even First World countries to start making it in local ad hoc ways, using the WHO guidelines as opposed to buying it from big international companies.
“In Switzerland, perfume companies started making hand rub for us, on a large scale so the community could benefit and reduce the cost maximally,” he said. Prof Pittet was disappointed France needed a decree to stop companies trying to profit by putting prices up steeply. “Hand rub has helped to control Covid in many places and this is very satisfactory to me. It was the same with H1N1 [swine flu] in 2009, but even more so now – if you want to go back to work in places where you don’t have access to water or soap, you need to use it for hand hygiene.”
Prof Pittet said he is very proud of being made a CBE in 2007 linked to work promoting hospital hygiene in the UK.
William Griffiths said: "Looking back I find this history fabulous and we have done something tremendous for humanity and we have have no 'conflict of interest'. We have not worked for companies or for money.
"I think that what Didier accomplished is fantastic and I am proud to have worked with him. I am 80 years old this year and I am proud of what I did with Didier and the ABHR [alcohol-based hand rub] in this year of the fight against Covid-19. I have received calls, letters and emails from many people in the last few months thanking me for my inventions."
As for buying gel, Prof Pittet advises using hospital-grade rubs showing the EN1500 norm. He believes the epidemic is under good control in Switzerland and in France the key is to follow the government’s advice, which “will certainly be effective at controlling the outbreak and future waves”.
“If we are prudent in the way we start again with activities, we will be fine,” he said.