By: Kerry Gallo, Children Without Worms

World Water Week in Stockholm presents an opportunity for those of us working in the field of neglected tropical diseases (NTDs) to communicate a clear and unified message to the water sector: by working together, we can make a difference in the lives of millions of people around the world.

Treatment through preventive chemotherapy alone does not break the transmission cycle of many NTDs. Many require environmental improvements to water and sanitation systems coupled with behavior change to promote lasting effects on the health of communities. Effective control strategies for several NTDs such as soil-transmitted helminthiasis (STH), trachoma, and schistosomiasis require that communities have access to water and latrines to break the cycle of infection.

Washing foods and hands with soap and water is a critical barrier against infection from STH and other parasitic worm infections. Face-washing to cleanse the eyes of infectious discharge that attracts disease-carrying flies and washing soiled clothing and bedding prevent the spread of bacteria that cause blinding trachoma. Preventing children and adults from swimming, washing clothes, and collecting water in contaminated streams by providing a source of clean water breaks the transmission cycle of schistosomiasis.  In addition, patients suffering from lymphedema, caused by lymphatic filariasis, are encouraged to wash their limbs regularly to prevent infections. Behaviors and actions such as these are needed to prevent infection and morbidity, but in communities where water is scarce and every drop is precious, none will be used for handwashing, bathing, or cleaning if it means going thirsty instead. In communities where water is contaminated and no other sources of water are available, people are left with little choice but to risk infection in order to carry out their daily tasks.

Through effective communication, NTD control and water improvement projects can be synergized to complement and strengthen one another. Monitoring and evaluation efforts will provide both sectors with information on project effectiveness and guidance for future work. For example, prevalence of NTDs can be used to prioritize communities in need of water and sanitation facilities.  For the NTD sector, information on where water and sanitation facilities exist or do not exist can help identify areas that should be prioritized for preventive chemotherapy. In addition, improving access to clean water and sanitation facilities will have the added effect of enabling the NTD sector to incorporate a robust approach to prevention by ensuring that the behaviors encouraged are practical, achievable, and appropriately practiced.

The intertwined nature of water and sanitation issues and NTD control shows that our two sectors should work together in partnership to improve the health of communities and maximize impact. Children Without Worms and our partners in NTD control look forward to new opportunities to collaborate with the water sector to implement the ideas and initiatives that have been discussed this week in Stockholm. It’s the surest way to reach those in need and achieve the desired impact for both initiatives.

Children Without Worms oversees the donation of mebendazole by Johnson & Johnson and albendazole by GlaxoSmithKline to treat children infected and at-risk of soil-transmitted helminthiasis. (www.childrenwithoutworms.org)