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November 28, 2005
Clean water, sanitation critical to global health

By Holly Korschun

A concerted effort by governments and organizations around the world to provide access to clean drinking water and adequate sanitation would alleviate many diseases that plague developing nations, according to a recent research commentary by Emory scientists. The commentary by James Hughes, director of the Center for Global Safe Water in the Rollins School of Public Health, and Jeffrey Koplan, vice president for academic health affairs, was published in the October issue of Emerging Infectious Diseases.

According to Hughes and Koplan, unsanitary water is largely responsible for diarrheal and related diseases, which were the third-leading cause of death in children under 5 years of age from 2000–03. The World Health Organization has estimated that almost 90 percent of deaths from diarrheal diseases are linked to unsafe drinking water and poor sanitation. Experts estimate that one-sixth of the world’s population (about 1.1 billion people) do not have access to clean drinking water, while another 2.6 billion people live without adequate sanitation.

Some governmental and private organizations have recognized the problems these conditions pose to developing countries and have taken steps to implement solutions. In 2000, member states at the United Nations Millennium Summit set eight Millennium Development Goals, one of which was to ensure environmental sustainability around the world. Part of this goal was to achieve a 50 percent reduction in the proportion of people without access to safe drinking water and basic sanitation by the year 2015. Other public and private sector organizations like CARE, Proctor & Gamble, The Coca-Cola Company and Starbucks (through its recent acquisition of Ethos Water) also have contributed through various projects and initiatives.

But Hughes and Koplan said there is still much work to be done.

“There’s a continuing need to draw attention to these issues and intervene to help reduce mortality and increase the quality of life in these countries,” Hughes said. Organizations like the Center for Global Safe Water have the opportunity to make a difference “through their expertise and evaluation of projects and techniques,” he added.

The most basic and important efforts would focus on providing access to safe water, basic sanitation and improved hygiene worldwide. Such an initiative would require collaboration by the world’s governments and organizations, which would need to agree on strategies, roles and responsibilities to maximize their efforts’ effectiveness.

Also, novel approaches to improving water, sanitation and hygiene quality should be explored and tailored to address specific local situations, Hughes and Koplan wrote. Increases in hand-washing with soap in African refugee camps and urban slums in Asia, along with in-home disinfection of drinking water in Kenya, are two examples of innovative approaches that have helped lower the incidence of diarrheal diseases in these areas.

Recent catastrophic events such as the tsunami in Asia and hurricanes Katrina and Rita on the U.S. Gulf Coast have emphasized the importance of addressing water and sanitation problems everywhere, especially after natural disasters. But the researchers stressed that a much stronger commitment is necessary to adequately address these global public health concerns and break the cycles of disease and poverty that dominate life in developing countries.

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