To Cure Disease, Prevention Must Come First

Date: 20th April 2017

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Credit: SWA

by Chris W. Williams
Executive Director of the Water Supply and Sanitation Collaborative Council

This article also features on our partner Sanitation and Water for All (SWA)’s website

Every day, an estimated 1,500 children die from diarrhea largely caused by a lack of access to safe water, sanitation, and hygiene — more than AIDS, malaria, and measles combined. Poor sanitation alone may also be responsible for as much as half of the world’s stunting problems, due to diarrhea and related malnutrition. And inadequate sanitation prevents people from attending work and school due to illness, costing poor countries USD 260 billion a year in lost revenue, according to the World Bank.

And yet these health, economic, and productivity burdens are entirely preventable. The provision of adequate sanitation and hygiene services are not only a human right, but there is ample evidence that sanitation and hygiene are the most cost-effective health interventions available. Notably, for every dollar invested in water and sanitation, there is a $4.3 return in the form of reduced health care costs for communities around the world, according to the WHO. The challenge for governments should therefore be disease prevention rather than cure, and government health ministries should prioritize funding and attention for services that avert the spread of disease rather than seek to treat it, therefore saving costs down the road.

The good news is that the expertise, innovations, and solutions necessary for sustainable disease prevention are available and just waiting to be tapped. Government investment in local, innovative, and scalable delivery models can improve the health, wealth, and productivity of its citizens. The challenge, therefore, is to identify the relevant vehicles for low-cost, sustainable, and scalable development programs that can strengthen preventive services and allow health ministries to take a more proactive stance on delivery mechanisms.

The Global Sanitation Fund (GSF), a fund administered by my organization, the UNOPS-hosted Water Supply and Sanitation Collaborative Council (WSSCC), invests in behaviour change activities that enable large numbers of people in developing countries to improve their sanitation and adopt good hygiene practices. The only global fund solely dedicated to sanitation and hygiene, the GSF is light on foot and heavy on scale. Households and local governments work with local entrepreneurs and a network of hundreds of partners. Together, they create the conditions for tens of millions of people to live in open defecation free environments and access adequate toilets and handwashing facilities.

In countries throughout sub-Saharan Africa the GSF works in partnership with health ministries to design, guide and monitor sanitation and hygiene improvement programmes that promote collective behaviour change at scale, also elevating preventive services and environmental health.

In Uganda, the Ministry of Health and the GSF work together in 30 districts to strengthen the country’s decentralized health system and reduce the burden of disease. In 2015, an analysis showed a downward trend for dysentery, intestinal worms, and cholera, as a result of improved sanitation and hygiene services. Similarly, in Ethiopia, the GSF supports the delivery of health services, and is aligned with Ethiopia’s 20-year strategy to achieve universal health coverage. The GSF programme, administered by the Ministry of Health, works in 40 woredas (districts) to train health extension workers and women leaders in the Community-Led Total Sanitation and Hygiene (CLTSH) approach.

These are just two examples of governments recognizing the need for strengthened preventive services, and working with an innovative and results-driven organization to deliver results at scale. By identifying the solution, investing in human resources, and scaling up its programming, these countries and many more will reduce their expenses and, more importantly, empower their citizens to improve their health and be more productive, healthy, and dignified.

These critical, yet pragmatic tactics to promote disease prevention services will require the focused attention and resources from governments and communities alike. However, the likelihood of these gaining traction is greater because of the commitments made by 182 Member States in September 2015 with the adoption of the Sustainable Development Goals. Rather than being confined to one goal, the possibilities for sanitation and hygiene to influence the 17 other goals are clearer than ever before in the roadmap to 2030.

Governments and communities can enhance efforts to improve policy, budgets and programme design to ensure that health prevention are a top priority. Together, we can improve the suitability of health services, so that sanitation and hygiene is a reality for everyone, everywhere.

The 2017 SWA High-level Meetings (HLMs) are taking place in Washington D.C., USA. They  comprise a Finance Ministers’ Meeting (FMM), convened by the World Bank on behalf of the SWA partnership, on 20 April. In the preceding days, 19 and 20 April, a Sector Ministers’ Meeting (SMM) will be convened by UNICEF, involving those ministers responsible for water, sanitation and hygiene who have accompanied their finance counterparts.#HLM2017

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