A bold new effort on neglected tropical diseases starts with water, sanitation and hygiene

Posted 11 Sep 2015 by Margaret Batty

Neglected tropical diseases affect the world’s poorest people, and cannot be treated and prevented effectively without safe water, sanitation and hygiene. Margaret Batty, WaterAid’s Director of Global Policy and Campaigns, discusses a new global strategy by the World Health Organization (WHO) which promises to incorporate these vital services to tackle such infections.

Neglected tropical diseases (NTDs) — including intestinal worms, guinea worm disease, blinding trachoma, and schistosomiasis — are a diverse group of infections with tragic common denominators. With a few exceptions, they are infections experienced almost exclusively by the world’s poorest and most marginalised people, often in remote and rural locations, or in conflict zones.

Now a new global strategy and action plan unveiled by WHO on 27 August in Stockholm, Sweden, during World Water Week, promises to bring faster progress to the more than 1 billion people affected by these diseases by incorporating the concepts of safe water, good sanitation, and handwashing and facewashing with soap into other public health interventions to tackle NTDs. 

Children washing their hands at a tap.
Students of Ras Ze Sillassie Elementary and Junior School enjoy the newly available clean water during their break. 

A clear solution

It seems so simple, even obvious, that including these basic building blocks for health will be critical if we are to control, eliminate or eradicate these terrible diseases by 2020.

We know that, today, more than 650 million people do not have access to clean water and more than 2.3 billion do not have access to a basic, private toilet. Most, if not all, of the more than 1 billion people who suffer from NTDs are included in these numbers.

Making sure families have access to safe water for drinking, cooking and washing, and ending open defecation, which spreads the parasites and bacteria that cause many of these diseases, helps stop transmission and makes treatments more effective.

Dr Maria Neira, WHO’s Director for Public Health, Environmental and Social Determinants of Health, said in Stockholm at the strategy’s unveiling: “Millions suffer from devastating WASH-related neglected tropical diseases such as soil-transmitted helminthiasis, guinea worm disease, trachoma and schistosomiasis, all of which affect mainly children. Solutions exist, such as access to safe water, managing human excreta, improving hygiene and enhancing targeted environmental management. Such improvements not only lead to improved health, but also reduce poverty.”

WaterAid has been working since 1981 in some of the world’s poorest communities to deliver clean water. This year, we too embarked on a new strategy of our own, focused on making our work stronger and more impactful through strong leadership, active communities, a focus on sustainable work, equality and integration between development sectors.

Results through collaboration

Joining up doesn’t always come naturally to those of us in development — we are used to focusing on our own sectors. Often health programmes targeting diseases focus more on medical intervention rather than prevention. To be most effective we need to package these together. This strategy will help us to improve joint efforts and, most importantly, to target our work where it is needed most.

This year is a critical year for development — we are just one month away from the signing of new Global Goals For Sustainable Development (GGs) at the UN. These 17 goals, which aim to eradicate poverty and tackle climate change and inequalities, include one to reach everyone everywhere with access to clean water, sanitation and hygiene by 2030.

If we are to succeed in this and in other goals on health, education and gender equality, development sectors need to work together to make sure the root causes of poverty and ill-health are addressed as a package.

WASH works

The GGs are a challenge to the world to leave it better for the generations to come, and we will not succeed if we do not join important health interventions with prevention, ensuring communities have safe water for drinking, cooking and washing, that human waste is handled hygienically with proper sanitation so that diseases are not further transmitted, and that good hygiene practice is both possible and carried out.

We know that this works. At Ras Ze Sillassie School in Wolkitie, Ethiopia, teachers have told WaterAid that before a school water, sanitation and hygiene (WASH) programme was installed in autumn 2014, trachoma and other serious eye infections were common among students. Now, however, students can wash more frequently and suffer fewer infections.

Eighth-grade student Tekalign, 14, has required eye injections and treatment for infection since he was 11. “My eyes need frequent washing. However there was either no water, or there were too many students waiting in line during the break. So I could not get to wash my eyes as frequently as I needed and it made things worse and affected my education. But now that there is water in the school and the 14 faucets spread out the queue a lot, I get to wash my eyes much more frequently than before,” he said.

In this case, the programme’s success has gone beyond the addition of a clean water source, handwashing facilities with soap and new latrines. Inclusion of disabled students, and programmes that encourage students to take pride in and maintain these new services and take lessons on hygiene behaviour home, are also important if we are to tackle the spread of these diseases and help ensure the voices of those people affected are better heard in their communities.

This new WHO drive to tackle these difficult diseases affecting some of our world’s most vulnerable people will be an important tool in efforts to bring an end to this suffering, and create a fairer, more sustainable world.

Margaret Batty is Director of Global Policy and Campaigns at WaterAid. She tweets as @margaretbatty and you can read more of her work here.


Add your comment


  • Ross Bailey said:

    13 Sep 2015 19:28

    An excellent blog Margaret. Work on NTDs is very much the litmus test of whether WASH interventions are reaching the poorest of the poor,

  • Emily Fyson said:

    18 Sep 2015 14:03

    Great blog Margaret - thanks! A really strong rallying call for WASH to be integrated with other sectors, and fantastic to see WaterAid collaborating with WHO.

  • muita said:

    2 Jun 2016 11:22
    Tropical and infectious diseases remain the most important health problems in developing countries. In children, measles, diarrhoea, malaria and acute respiratory infections kill millions worldwide whereas in adults, sexually transmitted diseases, HIV/AIDS, parasitic and other protozoal infections, tuberculosis and malignancies associated with viral infections are major causes of morbidity and mortality.
    The impediments to the control of these diseases in developing countries are many. For many immunizeable diseases, solutions exist but have not been implemented for financial or logistical reasons; for others such as waterborne diseases, we have solutions but do not yet know how best to apply them; and for a third category such as HIV/AIDS, solutions remain a hope for the future.

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