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Guinea Worm And Cholera Could Be A Thing Of The Past If Right Decisions Are Made At The World Health Assembly

September 28, 2017

Leaders at this week's World Health Assembly (WHA) in Geneva could miss the last hurdle in finally ridding the world from a debilitating disease unless they take vital steps to address the global water crisis, said WaterAid today.

The world is on the verge of eradicating dracunculiasis, a waterborne parasitic disease caused by guinea worm, which remains in only four countries - Mali, Ethiopia, Sudan and Ghana. If completely eradicated, guinea worm would become only the second disease wiped out by humankind - the first since smallpox was eradicated in the 1970s.

Significantly, of the four countries in which the disease is endemic, two are off-track to achieve the Millennium Development Goal (MDG) target on drinking water (Ethiopia and Sudan). And while Ghana has achieved the MDG water target and Mali is on-track to do so by 2015, there are vast inequalities within each country, meaning the poorest people without access to safe water are at risk from the disease, along with many other deadly water-related infections such as cholera and typhoid.

"The key to preventing the spread of guinea worm is having a clean water supply," explained WaterAid Senior Health Policy Analyst Yael Velleman. "The international community has been working on eradicating this disease for more than 20 years and we are now at the last hurdle. This is truly an historic time for us to rid the world of this disease forever and access to safe water is the key to doing this." The guinea worm lives in stagnant water. When people drink contaminated water, the parasite grows up to three feet and lives just below the skin, often crippling its human host. There are no medicines to treat the disease or vaccines to prevent it. The only cure is to slowly, painfully extract it over days. While the disease is not lethal, its disabling effect prevents those affected from working or attending school, putting already vulnerable individuals and community at risk of chronic poverty.

WaterAid is calling on Member States at this week's Assembly to support the four countries affected to improve access to safe drinking water and reach their most vulnerable populations to ensure the disease is finally eradicated with no chance of return. The international development agency is also calling for more coherence between the water and health sectors, who do not currently work together in most developing countries.

"Given that guinea worm is close to being eradicated, it is critically important to ensure that it does not propagate due to inadequate drinking water supplies, and weak relationships between the health and water communities," added Velleman.

Cholera a thing of the past

WaterAid also reminded leaders that access to clean water and sanitation is also the key to success in tackling other significant global health problems, including cholera.

"In the past 12 months we have seen the devastating effect that cholera has on the world's poorest people," said Velleman. "Recent outbreaks such as those seen in Haiti or Nigeria would not have occurred if access to safe water and sanitation facilities was secured."

WaterAid is calling on leaders to ensure that sanitation and water are prioritised in a resolution on controlling and preventing the deadly disease, which is due to be discussed and approved by the Assembly this week.

While the World Health Organisation has repeatedly stated that efforts to address cholera should be focussed on improving water and sanitation, there has been a strong push for stricken countries to adopt the use of oral vaccines. WaterAid warned that vaccines must not be the sole method of containing cholera, but that they should be part of a comprehensive strategy to prevent the disease.

"The development of safe, effective and potentially affordable oral cholera vaccines is important, however it is imperative that this approach is complementary to, and should not substitute for, the existing effective prevention and control measures; particularly safe water and sanitation," said Velleman.

The WHO estimates that 10% of global disease burden could be prevented with safe water, sanitation and hygiene. These basic services are critical in tackling some of the leading causes of child mortality such as diarrhoea, which alone kills more children each year than AIDS, malaria and measles combined. Half of the developing world's hospital beds filled with patients suffering from sanitation and water-related diseases, compounding the challenges faced by over-burdened and under-resourced health systems.

Almost one billion people live without access to safe drinking water and some 2.6 billion people do not have access to basic sanitation.