Water, Sanitation and Hygiene: closing the gap to end neglected tropical diseases

Today, on World Water Day, the World Health Organization (WHO) released its strategy on water, sanitation and hygiene as part of joint efforts by the water, sanitation and hygiene (WASH) and the neglected tropical diseases (NTD) sectors towards ending these diseases over the next decade.

The ‘‘Global Strategy on Water, Sanitation and Hygiene to Combat Neglected Tropical Diseases – 2021-2030’’ complements the recently launched new NTD road map and aligns with the Sustainable Development Goal targets 6.1 and 6.2 on drinking water and sanitation.

“Closer coordination and collaboration between the two sectors are critical for NTD elimination,” said Dr Maria Neira, Director, WHO Department of Environment, Climate Change and Health. “Good hygiene and access to water and sanitation are important in the prevention, care and management of all 20 diseases of poverty that massively impact the health of over one billion people.”

Increased collective action will require stronger political leadership and long-term, smart investments that recognize WASH as a foundational pillar to public health. The objectives of the strategy include:

• Increasing awareness on the co-benefits of WASH and NTDs and engagement at national and global levels
• Sharing data to highlight inequalities, target investment, and track progress
• Generating high-quality evidence and embed them within guidance and national strategies
• Joint planning, delivery and evaluation of programmes to enhance accountability, sustainability and equity.

“This strategy prioritizes quality research and data-driven evidence for decision-making and facilitates the joint implementation of life-saving and life-improving NTD programmes” said Dr Mwelecele Ntuli Malecela, Director, WHO Department of Control of Neglected Tropical Diseases. “It will guide the scale-up of essential WASH and health services and contribute to the NTD road map’s target of providing 100% access to basic water, sanitation and hygiene in areas endemic for NTDs”.

Without clean water and soap, it is difficult to implement simple and effective public health actions that can prevent and manage debilitating NTDs: face-washing for trachoma, a disease which leads to painful, irreversible blindness; limb-washing for lymphatic filariasis, in which worms invade the lymph system and cause severe oedema, especially of the legs; wound-washing for rabies, where cleaning the lesion thoroughly after a dog-bite can decrease the chances of infection by the virus from canine saliva; and hand-washing for intestinal worms, whose eggs are ingested with food inappropriately manipulated and contaminated with soil.

Large inequalities in access to WASH continue to persist: at least 2 billion people rely on water supplies that are unsafe; 673 million practice open defecation s, and, an estimated 3 billion people have no access to basic handwashing facilities¹ to practice personal hygiene.

The need for a joint WASH/NTD initiative to integrate the relatively unconnected activities of these two important sectors became evident after the publication of the first NTD road map in 2012. This led to the publication, in 2015, of the first strategy and action plan² that provided a framework for collaboration and joint planning, delivery and evaluation of programmes.

Currently, several countries plan to set up new coordination systems, and strive to increase the availability and quality of data on WASH and NTDs, to ensure that WASH services are directed at the communities in greatest need.