Four papers released today in PLoS Medicine—the flagship medical journal of the open access publisher Public Library of Science— highlight how sanitation and water, along with better hygiene, are the “forgotten foundations of health”. The series asks how the opportunity to save so many lives is failing to attract the attention of the international health community.
The scale of this crisis and the burden it places on global health and development is ominous. Unsafe sanitation and drinking water, as well as hygiene, account for nearly 20 per cent of all child deaths in the world and at least 7 per cent of the total global disease burden. In 2010, almost one fifth of the world’s population still defecate in the open and 2.6 billion people do not have access to even a basic toilet.
This renewed focus on sanitation comes ahead of World Toilet Day on 19 November—an international day to raise awareness of the global sanitation crisis. The series also coincides with the launch of the SHARE Consortium, an initiative funded by the UK’s Department for International Development to undertake research to improve sanitation and hygiene in poor countries.
Professor Sandy Cairncross, Research Director of SHARE and lead author of the series, said: “For me, there is no greater indictment of our age than that we continue to allow millions of children to die from entirely preventable diseases. The centrality of sanitation and water and hygiene to health has been made clear in numerous international declarations, but sadly this has not translated into progress on the ground.”
Adds Jon Lane, the WSSCC Executive Director who co-authored the paper on sanitation and health, “The health sector has a strong role to play in improving sanitation in developing countries through policy development and the implementation of sanitation programmes. We hope this series will help inspire them to do so.”
Most of these diseases, including diarrhoea cholera and typhoid can easily be prevented with cheap and proven interventions, such as pit latrines and hand-washing with soap. Despite this, and according to the series, progress has been “painfully slow” in many developing countries. This series gives evidence and urges members of the health community, from international donors and UN agencies to developing country governments, to take immediate action to reduce this “devastating disease burden.”
The four papers emphasize the effectiveness of local solutions and the importance of health professionals working with counterparts from other sectors. The series issues a call for:
The urgency of these actions is strongly emphasised, particularly as coverage will have to increase markedly to keep pace with rapid population growth in towns and cities.
“Children are dying every day from diseases such as diarrhoea, even though we know how to prevent them,” said Clarissa Brocklehurst, chief of Water and Sanitation for UNICEF. “We must work hand in hand – health professionals alongside engineers – to ensure that improvements in water supply, sanitation and hygiene reach everyone.”
“We can no longer stand by and ignore the crucial underlying role that these interventions play in health and development.”
PLoS Medicine series on water & sanitation
On 16 November the entire series will be accessible at
Paper 1: Hygiene, Sanitation, and Water:
Forgotten Foundations of Health
Citation: Bartram J, Cairncross S (2010) Hygiene,
Sanitation, and Water: Forgotten Foundations of Health. PLoS Med 7(11):
Published 9 November 2010
Paper 2: Water Supply and Health
Citation: Hunter PR, MacDonald AM, Carter RC (2010)
Water Supply and Health. PLoS Med 7(11): e1000361.
Published 9 November 2010
Paper 3: Sanitation and Health
Citation: Mara D, Lane J, Scott B, Trouba D (2010)
Sanitation and Health. PLoS Med 7(11): e1000363.
Published 16 November 2010
Hygiene, Sanitation, and Water: What Needs to Be Done?
Citation: Cairncross S, Bartram J, Cumming O,
Brocklehurst C (2010) Hygiene, Sanitation, and Water: What Needs to Be Done?
PLoS Med 7(11): e1000365. doi:10.1371/journal.pmed.1000365
Published 16 November 2010
The International Initiative for Impact Evaluation (3ie), a WSSCC partner, has updated the Evidence Gap Map (EGM) that provides an analysis of 41 systematic reviews and 317 impact evaluation studies in low- and middle-income countries (L&MICs). The analysis is based on the impact of WASH promotional approaches on behaviour change, health and socio-economic outcomes in […]
Click here for information in Arabic, French, Chinese, Portuguese, Russian and Spanish. India has taken massive strides towards achieving universal safe sanitation. The number of people without access to toilets in rural India has gone down from 550 million in 2014 to less than 150 million today, through an intensive behaviour change campaign, the Swachh […]
Dans les décennies à venir, il y a fort à penser que les plus grands problèmes de ce monde persisteront, tout comme des millions de personnes continueront de se sentir laissées pour compte face aux forces de la mondialisation. Seul un changement rapide et radical pourrait déjouer cette prédiction. Il appartient donc aux États, aux […]
One safe prediction for our world in the next future is that the biggest global problems will not disappear, and millions of people will keep feeling left behind by the forces of globalization unless we take immediate radical action. Governments, civil society organizations, development partners and businesses must increase their joint efforts to achieve the […]