Progress in sanitation needed for neglected tropical diseases

Abstract

On March 22, World Water Day, there is some good news to celebrate. According to a new report, Progress on Drinking Water and Sanitation 2012, released by WHO and UNICEF on March 6, part of Millennium Development Goal (MDG) 7—halving the proportion of people without sustainable access to safe drinking water—was met in 2010. 89% of the world's population, or 6·1 billion people, have access to improved drinking water sources, estimated to rise to 92% by 2015. Although there is still unacceptable inequality, this progress is encouraging.The same cannot be said for the other part of MDG 7—halving the proportion of people without access to basic sanitation. Progress here is shockingly slow. Only 63% of the world's population have access to basic sanitation and the projection for 2015 is 67%, well short of the target of 75%. Even in countries with vastly improved economic outlooks, such as China and Brazil, 14 million and 7·2 million people, respectively, practice open defecation. A quarter of people in the least developed countries have no access to toilets or latrines. Improving sanitation and hygiene is not at the forefront of development aid despite its obvious preventive effects on many infectious diseases, including most neglected tropical diseases.Indeed, at the launch of the WHO roadmap for Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases, discussed earlier this year at a seminal meeting in London, only passing comments to improvement of water and sanitation were made. Out of five recommended strategies, provision of safe water, sanitation, and hygiene came last, almost as an afterthought without urgency or hope for improvement. No specific targets and goals were included in the context of neglected tropical diseases, nor was it clear who from this new partnership will take up this task.Without attention to this basic right, elimination and certainly eradication of these diseases will remain an unachievable dream. Until sanitation and universal access to toilets and latrines becomes an urgent priority discussed openly and forcefully by all who aim to improve global health, progress will be hampered by our own reluctance to tackle this obvious source of ill-health. On March 22, World Water Day, there is some good news to celebrate. According to a new report, Progress on Drinking Water and Sanitation 2012, released by WHO and UNICEF on March 6, part of Millennium Development Goal (MDG) 7—halving the proportion of people without sustainable access to safe drinking water—was met in 2010. 89% of the world's population, or 6·1 billion people, have access to improved drinking water sources, estimated to rise to 92% by 2015. Although there is still unacceptable inequality, this progress is encouraging. The same cannot be said for the other part of MDG 7—halving the proportion of people without access to basic sanitation. Progress here is shockingly slow. Only 63% of the world's population have access to basic sanitation and the projection for 2015 is 67%, well short of the target of 75%. Even in countries with vastly improved economic outlooks, such as China and Brazil, 14 million and 7·2 million people, respectively, practice open defecation. A quarter of people in the least developed countries have no access to toilets or latrines. Improving sanitation and hygiene is not at the forefront of development aid despite its obvious preventive effects on many infectious diseases, including most neglected tropical diseases. Indeed, at the launch of the WHO roadmap for Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases, discussed earlier this year at a seminal meeting in London, only passing comments to improvement of water and sanitation were made. Out of five recommended strategies, provision of safe water, sanitation, and hygiene came last, almost as an afterthought without urgency or hope for improvement. No specific targets and goals were included in the context of neglected tropical diseases, nor was it clear who from this new partnership will take up this task. Without attention to this basic right, elimination and certainly eradication of these diseases will remain an unachievable dream. Until sanitation and universal access to toilets and latrines becomes an urgent priority discussed openly and forcefully by all who aim to improve global health, progress will be hampered by our own reluctance to tackle this obvious source of ill-health.