The United Nations introduces us to the challenges of water. “Water is the essential building block of life. But it is more than just essential to quench thirst or protect health; water is vital for creating jobs and supporting economic, social, and human development.” Unfortunately, “Today, there are over 663 million people living without a safe water supply close to home, spending countless hours queuing or trekking to distant sources, and coping with the health impacts of using contaminated water.”
Many of the infectious health challenges known as Neglected Tropical Diseases (NTDs) have issues of water associated with their transmission. This may relate to scarcity of water and subsequent hygiene problems. It may relate to water quality and contamination. It may also relate to water in the lifecycle of vectors that carry some of the diseases.
Even though water is crucial to the control of many NTDs, it is not often the feature of large scale interventions. The largest current activity against five NTDs is mass drug administration (MDA) on an annual or more frequent basis to break the transmission cycle. Known as diseases that respond to preventive chemotherapy (PCT) through MDA, these include lymphatic filariasis (LF), trachoma, onchocerciasis, schistosomiasis and soil transmitted helminths (STH) has been undertaken for over 10 years.
We have recently passed the Fifth Anniversary of the London Declaration on NTDs, which calls for the control of ten of the many these scourges The Declaration calls for “the elimination “by 2020 lymphatic filariasis, leprosy, sleeping sickness (human African trypanosomiasis) and blinding trachoma.” Another water-borne NTD, guinea worm, should be eradicated soon. Two of the elimination targets are part of MDA efforts, LF and trachoma.
Ministries of Health and their donor and NGO partners who deliver MDA against the 5 diseases in endemic countries express interest in coordinating with water and sanitation for health (WASH) programs. People do recognize the value of collaboration between NTD MDA efforts and WASH projects, but these may be located in other ministries and organizations.
The long term implementation of WASH efforts is seen as a way to prevent resurgence of trachoma, for example, and strongly compliment efforts to control STH and schistosomiasis. Hopefully before the 10th Anniversary of the London Declaration the vision of “ensuring access to clean water and basic sanitation,” can also be achieved.
Finally as a reminder our present tools for the control of Zika and Dengue fevers relies almost entirely on safe and protected household and community sources of water to prevent breeding of disease carrying Aedes aegypti mosquitoes. If we neglect water, we will continue to experience neglected tropical diseases. Hopefully the topic of water and NTDs will feature prominently at next months global partners meeting hosted by the World Health Organization.