Most WASH-attributable deaths were reported from the WHO African and South-East Asia regions
Most WASH-attributable deaths were reported from the WHO African and South-East Asia regions. Photo for representation from iStock Unsafe drinking water, sanitation and hygiene (WASH) were responsible for 395,000 deaths among children under five years of age, according to a new report by the World Health Organization (WHO).
This includes 273,000 deaths from diarrhoea and 112,000 deaths from acute respiratory infections. These diseases are the two leading infectious causes of death in children under five years of age in the world.
The report, Burden of disease attributable to unsafe drinking water, sanitation and hygiene: 2019 update, showed that half of the world’s population still does not have adequate access to drinking water, sanitation and hygiene, which caused the death of at least 1.4 million people and 74 million disability-adjusted life years (DALY) in 2019.
Globally, 771 million people lack access to safe water and 1.7 billion people don’t have a toilet.
The WHO report is based on the estimates of the burden of diseases attributable to unsafe WASH — namely diarrhoea, acute respiratory infections, undernutrition and soil-transmitted helminthiases (STH).
Soil-transmitted helminthiases are transmitted by eggs in human faeces, which in turn contaminate soil in areas where sanitation is poor. STHs affect an estimated 1.5 billion people or 24 per cent of the world’s population.
The WASH-attributable burden of disease from STHs was estimated for 132 low- and lower-middle income countries (LMICs) only, as this is where these infections are most prevalent.
The assessments include data from 183 WHO Member States for the year 2019.
Diarrhoeal diseases accounted for the majority of the attributable burden according to WHO, with more than a million deaths and 55 million DALYs.
Acute respiratory infections caused by inadequate hand hygiene were identified as the second-largest contributor, with 356,000 deaths and 17 million DALYs.
It was estimated that 10 per cent of the burden of undernutrition — Protein-energy malnutrition (PEM) — among children under five could be attributed to unsafe WASH, representing a total of 8,000 deaths and 825,000 DALYs in this age group.
All the STH-related burden of disease was assumed to be attributable to unsafe WASH conditions, resulting in 2,000 deaths and 1.9 million DALYs in 2019.
There are significant disparities between regions and income groups, according to the report. Most WASH-attributable deaths were reported from the WHO African and South-East Asia regions.
Overall, almost 384,000 diarrhoea deaths and 20 million DALYs in 2019 were attributed to inadequate hand hygiene practices alone, largely in Africa and South-East Asia.
Nearly two of five deaths due to lack of sufficient access to water, sanitation and hygiene (WASH) are from 10 countries in sub-Saharan Africa (SSA), according to a report by UNICEF.
Some 89 per cent of deaths linked to unsafe drinking water, sanitation and hygiene occurred in LMICs.
In 2019, 35 per cent of diarrhoea deaths in LMICs were attributable to unsafe drinking-water, accounting for over 505,000 deaths and 27 DALYs.
Even high-income countries are at risk, as 18 per cent of their diarrhoeal disease burden could be prevented through improved hand hygiene practices.
In the region of the Americas, 33,200 people died from diarrheal diseases and 317,921 from acute respiratory infections in 2019.
The report also said climate change can impact WASH services in many ways including damage to water supply and sewerage infrastructure, degradation of catchments and source-water quality, spillage of faecal waste to the environment, reduction of water availability and contamination of water supplies.
Many countries have made rapid progress in improving access to WASH. In Jordan in 2015, 75 per cent of drinking-water services were safely managed; by 2020, this had risen to 86 per cent, an increase of more than two percentage points per year.
In another five countries — Gambia, Ghana, Lesotho, Morocco and Myanmar — coverage increased by more than five percentage points between 2015 and 2020.
Bangladesh, Indonesia, Mongolia, Pakistan and Sao Tome and Principe experienced the fastest progress on access to basic hand hygiene services, with coverage increasing by more than 10 percentage points between 2015 and 2020.
WHO has developed a tool to estimate health gains based on the latest available evidence linking WASH to disease burden. The tool automatically produces country-specific calculations of burden of disease tailored to user choices and enables simulation of health impacts based on various WASH scenarios.
WASH forms an integral part of health systems and is even more critical after COVID-19. Countries have formal policies and plans but face a big challenge in implementing them to reach water and sanitation targets.
Only three per cent of countries had a formal policy or a plan in place with at least 75 per cent costing plan available to implement these policies, the data showed.
To reduce the WASH-attributable burden of disease, WHO urges governments to take actions with support from UN agencies, multilateral partners, the private sector and civil society organisations.
We are a voice to you; you have been a support to us. Together we build journalism that is independent, credible and fearless. You can further help us by making a donation. This will mean a lot for our ability to bring you news, perspectives and analysis from the ground so that we can make change together.
.png)
Comments are moderated and will be published only after the site moderator’s approval. Please use a genuine email ID and provide your name. Selected comments may also be used in the ‘Letters’ section of the Down To Earth print edition.