Letís integrate Water, Sanitation and Hygiene into public health interventions for sustainability, says Amref Health Africa

International World Water Day 2015

The 2015 World Water Day comes at a time when the achievements of the Millennium Development Goals (MDGs) are being assessed and the international community is defining new Sustainable Development Goals (SDGs) for the years 2016 to 2030. These SDGs will guide global efforts to protect and develop water resources as well as to offer water and sanitation services to everybody within the next 15 years.

On the occasion of this year’s World Water Day, Amref Health Africa wishes to remind African Governments and the international community that limited access to clean water causes challenges for primary health care. Therefore drinking water supply and the provision of sanitation facilities form an indispensable element in disease prevention and primary health care programmes. The global situation regarding the availability of drinking water and sanitation facilities is dramatic: more than 1,500 million people lack proper facilities, and the implications in terms of health and cost are stupendous. It is encouraging that the post-2016 Sustainable Development agenda seeks to address this.

Amref Health Africa is a premier development partner in initiatives for improving access to water, sanitation and hygiene for inclusive and sustainable growth in Africa. Between 2011 and 2014, Amref Health Africa invested US $47.2 million on 105 water and sanitation projects focusing on health outcomes. The projects covered integration of Neglected Tropical Diseases and particularly the control and elimination of blinding trachoma.

Investments in universal access to water, sanitation and hygiene are estimated to save over $134 billion in annual health costs, lost productivity, and reduced mortality. Amref Health Africa has noted sadly that, despite its importance, this is among the most neglected areas in public health. The burden of water-related diseases therefore continues to curtail efforts to improve public health in sub-Saharan Africa. Diarrhoea – most often related to unsafe drinking water, poor sanitation and inadequate hygiene – is one of the leading causes of death among children under the age of five. In fact, diarrhoea kills more children than malaria or HIV/AIDS.

The WHO estimates that exposure to inadequate drinking water, sanitation and hand hygiene was responsible for 58 per cent of deaths from diarrhoea in 2014, adding up to 840,000 deaths in low and middle-income countries. This translates into 1.5 per cent of the global disease burden, and 5.5 per cent for children under five. There is also growing evidence that repeated exposure to unsafe drinking water, poor sanitation and inadequate hygiene have a significant impact on stunting. This comes about as a result of intestinal worm infections, diarrhoeal diseases and poor nutrition. Cholera is also transmitted via contaminated water. Several cholera outbreaks have killed hundreds people in Africa over the past few months, including about 87 in Malawi in 2015 alone.

From our experience working in communities for over 50 years, Amref Health Africa believes that water and sanitation programmes can only have a health impact if they are developed and managed in an integrated manner. Active involvement of public health professionals in hygiene, sanitation and water supply is crucial to accelerating and consolidating progress for health. Rather than focusing more on curative approaches as is currently the case, key development actors in the health sector should streamline drinking water, sanitation and hygiene into preventative medicine. Through a push for more funding and better policy design, tangible health benefits could be realised. And, most importantly, improvements will be made in the lives of millions of people in Africa for lasting health change.