COVID-19 was declared a pandemic on March 11, 2020, by the World Health Organization (WHO). It has been recommended that you should wear a mask, keep a safe distance and wash your hands regularly. 

According to WHO’s recommendations to improve hand hygiene practices, washing hands with water and soap frequently is one of the best ways to keep the hands clean and the other is using alcohol-based hand sanitizers (composed of ethanol or isopropanol, glycerol, and hydrogen peroxide).

Hand sanitizers are cleansing agents applied to the hands to kill viruses, bacteria, and microorganisms (disease-causing organisms). It can be found in a liquid, gel, or foam form. Depending on the active ingredient used, hand sanitizers can be classified as alcohol-based (which contain ethanol or isopropyl alcohol/ isopropanol) or alcohol-free (which contain Hydrochloric acid or benzalkonium chloride). Both types of sanitizers might also have ingredients such as Hydrogen peroxide, glycerol, water, and/or some fragrances.  

Likewise, the US Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) says sanitizers used for COVID-19 prevention should contain at least 60% alcohol. The Ethiopian Ministry of Health and Public Health Institute also recommends using alcohol-based sanitizer when water and soap are not available.

However, Addis Zeybe observed some alcohol-free sanitizers and disinfectants being sold in Ethiopia which claim to kill 99.99% of harmful viruses and bacterias, including the coronavirus. 

Addis Zeybe has analyzed what the recommended standard of hand sanitizers for COVID prevention is, talked with experts, and contacted stakeholders in Ethiopia. 

Addis Zeybe spoke with Mengistu Endalew, the deputy director of medicine facility inspection in the Ethiopian Food and Drug Authority. When asked about the efficacy of alcohol-free sanitizers which claim to be effective on COVID-19, Mengistu responded: “We give authorization based on the requirements and standards set by the Ethiopian Standard Agency, and we gave authorization for three alcohol-free sanitizers and many more alcohol-based alcohol-based sanitizer manufacturers.” He also added that the standard was authorized by different stakeholders like the Ministry of Health (MoH) and the Ethiopian Public Health Institute (EPHI). 

Looking into the standard, Haqcheck found that it doesn’t specify whether the products are for COVID-19 or not. 

Yilma Mengistu, director of standard developments at the Ethiopian Standard Agency, explained: “The way the standards are given is general and it doesn’t have specification for each product. 

“In this case, it doesn’t specify which product is effective for COVID-19. But there is an obligation to include the purpose of the product, spectrum of activity, the recommended method of application, application procedure, and other claims and uses of recommendation in the labelling. It is the way every standard is given.” 

 Addis Zeybe spoke with Dr. Kirubel Tesfaye (MD), a postgraduate student at the University of Barcelona. The health expert said: “Our society is living in a resource-limited country. I believe alcohol-based sanitizers are much cheaper to buy and have a superior action over their counterpart. 

Pointing to a research paper in the American Journal of Infection Control, Dr. Kirubel added: “If one cannot afford to buy an alcohol-based sanitizer there are videos showing how to prepare sanitizer. If someone has better access to non-alcohol-based sanitizers, they are as effective but they have to apply larger volumes.” 

Asked, “why does WHO still recommend the alcohol-based one?” Dr. Kirubel went on: “The WHO is waiting until more peer-reviewed publications on alcohol-free sanitizers come out, but both alcohol- and alcohol-free sanitizers are being marketed in Europe and the US as tackling COVID-19. Besides, the virus can effectively be prevented from spreading by hand by using soap and water. That may be the reason most products have comparable results”

With that being said, Saharele Abdulahi, state minister of health, said “It is known that the most effective and recommended hand sanitizer is alcohol-based, but due to the shortage of supply of alcohol (from the National Alcohol and Liquor Factory and the Ethiopian Sugar Corporation), we had to find another option to tackle the challenge. 

“We had a long debate with professional bodies and experts about the choices we had and decided to adopt what other countries are using, which was using alcohol-free sanitizers. And since there was a demand from manufacturers we took the only choice we had at the time.” 

Saharele emphasizes that the recommended hand sanitizer remains an alcohol-based one. But if it is not available, one can also use alcohol-free sanitizers. “It is at least better than nothing,” she said. Saharele added that ongoing research was still being conducted on coronavirus and there are always new discoveries. 

As most health experts and professional bodies agreed, using the alcohol-free sanitizer is an option if only one can’t get access to the alcohol-based one. Otherwise, washing hands with soap and water frequently and using alcohol-based sanitizer is the most effective and recommended to prevent the spread of COVID-19. 

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