Prevention as well as cure: You want to stamp out tropical disease? Put clean water, sanitation and hygiene at the top of your ‘to do list’.

The Gates Foundation conference today: has sparked an increase in the debate on how to tackle tropical disease, with DFID announcing a five-fold increase in its aid for this area last week. There is no doubt that working with the pharmaceutical industry to increase investment in the treatment:and in some cases eradication, of diseases, such as trachoma and guinea worm which can deform, disable, blind and kill, will be a great step forward.

However, in the current climate: where “value for money” is the mantra, shouldn’t we also be ramping up investment in the measures that stop people from getting sick in the first place? Basic hygiene: proper toilets, an uncontaminated water supply and simple hand washing, can stop these diseases spreading and destroying communities. Every 20 seconds a child under five dies in the developing world from a preventable illness. Clean up the water, and you’re going to make a huge difference.

Working alongside other NGO’s, Tearfund helps to run one of the few health centres in Motot, South Sudan. It offers immunisation, but also explains how a change of hygiene habits can prevent diarrhoea and stop babies getting sick. Families learn that washing their hands with soap after going to the toilet, or before eating, prevents these diseases like bilharzia (which kills 200,000 in Africa each year) from spreading spreading. Latrines too, help to control the flies that carry Chlamydia between children’s faces.

And in Parwan, in central Afghanistan, a low tech solution; Bio-sand filters, are helping to rid stream water of bacteria and worms. One woman told of how this had made a huge difference in her life.

‘We always used to drink from streams and all our children had diarrhoea. This meant high medical bills, because we didn’t understand the problems; the filter is a huge gift as our children are now better’.

In some ways this is stating the obvious.  We all reach straight for the bottled water when in unfamiliar territory to reduce the risk of picking up diseases.  However, what is less obvious is why there appears to be a false divide between those working on medical solutions and those working on water and sanitation – with an imbalance in funding available as well.  At a community level, health workers definitely see these issues as all part of the same problem, so shouldn’t we try to be a bit more “joined up” at the global level as well? It’s a humanitarian priority, and makes economic sense too.

There is some good news. The Sanitation and Water for All Initiative may not be as well known at the Global Fund for AIDS, TB and Malaria, or other global health initiatives, but it is doing great work behind the scenes to catalyse action to improve access to safe water and sanitation worldwide.  Just last week, due to the work of Sanitation and Water for All, Liberian President Ellen Johnson Sirleaf signed a compact which sets out how her government, alongside international donors, will prioritise action in this vital area in the years ahead. This investment will do much to reduce tropical disease in the country as well.

How can we encourage more governments, and donors, to get behind this and do the same?

Of course it’s positive that the Bill and Melinda Gates’ Foundation, governments, NGO’S and the private sector are all talking about tropical disease prevention around the table today. My message to all of them:  everyone gains if the health sector works with the WASH (water, hygiene and sanitation) sector, and investment in both – both financial and political capital – is vital. Maybe when Gates is next in town, we could have a conference on this?




  1. Ben Niblett says:

    And don’t the UNDP estimate each $1 spent on water and sanitation reaps $8 in economic return?

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