It's mind boggling. We have a cure to solve life-threatening global public health problems, yet we fail to apply it consistently. The cure, dubbed the most important medical advance of the 20th century by readers of the British Medial Journal, is basic sanitation, good hygiene and access to safe drinking water. This three legged stool--water, sanitation and hygiene-- is also known as "WASH."
More than 25 diseases are caused by inadequate water, sanitation and hygiene creating nearly 10% of the global public health burden, killing more than 2 million people a year (including more children than AIDS, TB and malaria combined) and leading to 50% of the world's malnutrition. Each year there are more than 4 billion cases of diarrhea (a consequence of many of these 25+ diseases), killing 1.5 million people, 90% of whom are children under five.
What is missing is a lack of will and financing to implement more WASH programs. The technology and knowledge exist.
To be serious about addressing this need, an additional global investment of $18 billion per year is required to meet the Millennium Development Goal (MDG) of cutting in half the percentage of people who are not currently served with WASH. While this would not solve the crisis it would make life-changing improvements in health for billions, as right now 2.5 billion people lack access to even a basic latrine. This is not hyperbole. This investment would save hundreds of thousands of lives and prevent millions of bouts of illness.
Appallingly, at present less than $2 billion in global health financing per year is going to tackle WASH-related diseases.
A Capitol Hill Briefing on July 29 co-hosted by the Congressional Water Caucus and Water Advocates pointed to evidence that inadequate water, sanitation and hygiene are the developing world's largest cause of disease. It revealed that WASH is also critical to sustainable progress across a broad spectrum of development needs--from hunger to environmental degradation.
Jae So, manager of the Water and Sanitation Program and a panelist at the briefing, noted that inaction has a real economic cost, giving the example of Cambodia where 7% of GDP is lost due to poor sanitation. "All of a sudden, the lack of sanitation became not a problem of the poor person that doesn't have access to sanitation, but it became a real constraint to economic growth in the country," she said.
Part of the reason for inaction is that the US public is largely unaware of the extent and severity of the WASH crisis, as few see the situation first hand. Although Americans 100 years ago suffered from WASH-related diseases, today we easily flush away potential pathogens with a twist of a toilet handle and have clean safe drinking water at the turn of a tap. However, this is a global problem that Americans can do something about now--the solutions may begin with just drilling a borehole well or getting more children to wash their hands with soap.
"The deaths and illnesses caused by unsafe drinking water and inadequate sanitation are arguably the world's most grave public health challenge; they are also the most solvable and preventable," Representative John Linder, a co-founder of the Water Caucus said in response to the briefing. "The United States has a great opportunity to take a global leadership position on this critical issue. Indeed, water scarcity and pollution affects everything from stability and security of communities and nations, human health, education, economic prosperity, humanitarian relief and stewardship of the physical environment."
There are two pieces of legislation in the US that if signed into law would provide more impetus to apply the WASH cure: The Senator Paul Simon Water for the World Act (S.624/H.R.2030) and the Newborn, Mother and Child Survival Act (H.R.1410) both of 2009. You can be a part of supporting these historic bills by asking your Senators and Representatives to co-sponsor them.
It's time to get back to basics and remember what we already know: WASH is Medicine. Let's start prescribing today.