PAHO/CDC/EPA Partnership Consultations at the Spanish Town
Treatment Plant with Jamaican officials from the National Water
Commission. (August 2006, Richard Davis)
Many households in developing countries lack adequate sanitation
facilities, water sources that are protected from microbial and chemical
contamination, and sufficient water supply to enable good hygiene practices.
Worldwide, deaths from preventable waterborne diseases are estimated at 5 to
10 million per year. Diarrheal diseases are the second leading cause of
death among children, killing an estimated 1.6 million each year, and
roughly 90% of these cases are related to environmental conditions. Further,
naturally-occurring arsenic and fluoride contamination of groundwater used
for drinking can cause cancer, bone malformations, and other diseases. Poor
management of standing water is linked to mosquito-borne diseases such as
dengue and malaria. Agricultural and industrial run-offs containing
fertilizers, pesticides, herbicides, and other chemicals can contaminate
water sources, and the long-term health effects of many of these chemicals
is as yet unclear. Finally, when water supplies are insufficient for
personal hygiene, diseases such as louse-borne typhus are more prevalent.
The World Health Organization estimates that 20% of the developing world
lacks adequate drinking water and 50% lacks improved sanitation facilities.
Although providing sustainable water supply and sanitation systems has long
been a global public health priority, large ongoing efforts are needed for
new construction to outpace population growth and decay of existing
infrastructure. A Millennium Development Goal calls for the percentage of
the population without sustainable access to safe water and sanitation to be
halved by the year 2015.
In addition to provision of water and sanitation, other interventions are
known to be effective in protecting health. For example, educating
individuals to wash hands with soap and water at critical times during the
day can reduce diarrhea rates by more than one-third. Treating impure
drinking water in the home to remove pathogens (through boiling, chemical
disinfection, or solar disinfection) has a similar impact. In fact, based on
a recent meta-analysis of studies on the topic, these two interventions may
be even more effective than simply improving water supply systems.
NCEH/ATSDR EXPERTISE AND EXPERIENCE
With public health partners, CDC promotes, designs, participates in, and evaluates environmental public health service programs to prevent and control diseases related to water supplies, sanitation, and poor hygiene practices. The NCEH/ATSDR approach to water, sanitation, and hygiene programs, known as WaterPlus / Agua y Más, focuses on Water Safety Plans (an approach to protecting water supplies through proactively assessing and preventing risks from catchment to consumer); integration of water supply with point-of-use water purification, sanitation, and hygiene elements as needed; and program evaluation.
Click here for a list of current NCEH/ATSDR projects related to this topic.