Among the resolutions debated at this week's World Health Assembly in Geneva, is an historic opportunity to finally rid the world of one of its most debilitating diseases: guinea worm.
Dracunculiasis, a waterborne parasitic disease caused by the guinea worm, only remains in four countries: Mali, Ethiopia, Sudan and Ghana. If completely eradicated, guinea worm would become only the second disease wiped out by humankind -- the first since smallpox was eradicated in the 1970s. It would be a great cause for celebration.
Guinea worm is an intrusive disease. The worm itself lives in stagnant, unsafe water. When people drink this contaminated water, the parasite enters their body and grows up to three feet long. It lives just below the skin, often crippling its human host. There are no medicines to treat the disease, nor vaccines to prevent it. The only cure is to slowly, painfully extract it over days. Sometimes the worm causes infections. This then leads to septicaemia, which by the time people get to clinics, often means that their limbs have to be amputated. While the disease is not lethal, its disabling effect prevents those affected from working or attending school, putting already vulnerable individuals and community at risk of chronic poverty.
The key to preventing the spread of guinea worm is having a clean water supply. However, of the four countries in which the disease is endemic, two are off-track to achieve the Millennium Development Goal (MDG) target on drinking water (Ethiopia and Sudan). And while Ghana has achieved the water target and Mali is on-track to do so by 2015, there are vast inequalities within each country, meaning the poorest people without access to safe water are those who suffer from the disease, along with many other deadly water-related infections such as cholera and typhoid.
If we want to truly rid the world of this scourge, we must support the four countries affected to improve access to safe drinking water and reach their most vulnerable populations to ensure the disease is finally eradicated with no chance of return.
There must also be more coherence between the water and health sectors, who do not work together in many developing countries. Responsibility for water provision often lies with Ministries of Water and Water Utilities, who do not assess their progress against health criteria; and the mandate for water quality monitoring is often held by the Ministry of Health. Such weak relationships between the health and water communities is an often fatal oversight, as together with having safe toilets and hygiene, access to clean water is one of the foundations good health.
In fact, the World Health Organisation estimates that 10 percent of global disease burden could be prevented with safe water, sanitation and hygiene. These basic services are critical in tackling some of the leading causes of child mortality such as diarrhoea, which alone kills more children each year than AIDS, malaria and measles combined. Half of the developing world's hospital beds filled with patients suffering from sanitation and water-related diseases, compounding the challenges faced by over-burdened and under-resourced health systems.
It is telling that this meeting of the World Health Assembly, the decision making body of the WHO, for the first time in its recorded history, is now considering three resolutions relating to water and sanitation, basic foundations for healthy living. The fact that these resolutions are being considered would seem to indicate that their centrality to addressing global health issues is becoming more widely recognized within the health sector.
However with almost one billion people without access to safe drinking water and some 2.6 billion people with no access to basic sanitation, there is a lot of work to be done to translate these policy discussions into action. Ensuring that we meet the last hurdle in eradicating guinea worm would be an important first step.