The World Health Organization (WHO) has released the publication titled, ‘Safer Water, Better Health,’ which estimates the burden of 12 major diseases and adverse health impacts due to inadequate Water Sanitation and Hygiene (WASH). The report also provides evidence for links between WASH and another 14 conditions, such as antimicrobial resistance (AMR), that are not yet quantified.

The report serves as an update and builds on the WHO’s previous analysis of environmental disease burdens and interventions. The agency’s (2016) findings showed that, globally, “1.9 million deaths and 123 million disability-adjusted life years (DALYs) could have been prevented with adequate WASH. The WASH-attributable disease burden amounted to 3.3% of global deaths and 4.6% of global DALYs.” Sub-Saharan Africa remains the region with the largest disease burden from inadequate WASH. 

The publication highlights the relationship between improper disposal of excreta, lack of hand washing facilities, and pathogens in drinking water on the prevalence of diarrhoeal diseases and respiratory infections. It describes how standing and wastewater are breeding grounds for mosquitoes, which serve as additional disease vectors. 

For the following diseases – diarrhoeal diseases; respiratory infections; soil-transmitted helminthiasis; malaria; trachoma; schistosomiasis; lymphatic filariasis; onchocerciasis; dengue; Japanese encephalitis; protein-energy malnutrition; drowning; arsenicosis ; fluorosis ; legionellosis; leptospirosis; hepatitis A and hepatitis E; methaemoglobinaemia; cyanobacterial toxins; lead poisoning; scabies; spinal injury; poliomyelitis; and adverse neonatal conditions and maternal outcomes – the report gives a detailed account of links to inadequate WASH. Where possible, it also describes interventions and gives economic evaluations.

The report draws particular attention to the impacts of inadequate WASH on young children, noting that, “among children under 5 years, WASH-attributable deaths represent 13% of deaths and 12% of disability adjusted life years (DALYs),” an outcome that could be prevented with existing prevention strategies and interventions. These interventions would include implementation of: water safety planning; guidelines for drinking-water quality; guidelines for safe recreational water environments; guidelines for drinking-water quality;  guidelines for safe use of wastewater, excreta and greywater; and sanitation safety planning to prevent exposure to excreta along the sanitation chain. [Publication: Safer Water, Better Health]