Water, Sanitation, Hygiene and HIV/AIDS

Thought I'd do a little research on the nexus of safe drinking water, sanitation, hygiene and HIV/AIDS tonight. I found a very interesting presentation given recently by USAID staffperson Merri Weinger at AfricaSan 2008 in Durban:

http://www.ehproject.org/PDF/ehkm/weinger-africasan2008_presentation.pdf
(PDF document)

It's a quick, introductory read. I'm not sure if you all will find anything new there but for me it does a good job of laying out the linkages between water, sanitation, hygiene and HIV/AIDS, and of quantifying the positive impact of WASH on HIV+ patients and to a certain extent the larger communities.

Note that Pepfar funds can be used for drinking water and hygiene improvements. Sanitation improvements (latrines) need outside sources of funding.

Page 14 discusses 'small doable actions' that need to be scaled up, out and over.

Then I thought of the ongoing debate (as seen in the recent LA Times article "Unintended victims of Gates Foundation generosity") between vertical (viz. disease-specific) and horizontal (viz. basic public health care) approaches to global public health challenges. The facts are, plenty of financial and political capital is flowing to one individual disease: HIV/AIDS. In my mind, it is premature to determine whether that is a good or bad idea (and there are others: malaria, TB). But how can the global watsan community work within the current situation of HIV getting a lot of attention and water getting relatively less?

Every water development organization (UNICEF, CARE, WaterPartners, WaterAid, Water For People, Living Water, and myriad others) that is working in a community where there are HIV positive people should approach Pepfar and ask for support for drinking water and hygiene promotion. Those water development organizations could make that more attractive to Pepfar by agreeing to provide sanitation facilities from their own funds. Essentially the water community should do a better job of grabbing onto the coattails of the HIV/AIDS juggernaut and get a bigger piece of the pie. The end game? - Every HIV clinic, and perhaps the surrounding families and communities could not only have ARVs and medical professionals trained in treating HIV, but also safe drinking water, sanitation and hygiene, and therefore significantly less diarrheal morbidity and mortality.

Where to Start in Africa?

William Easterly had an insightful piece "What Bono doesn't say about Africa" in the LA Times on July 6 which included:

...the typical African is a long way from being a starving, AIDS-stricken refugee at the mercy of child soldiers. The reality is that many more Africans need latrines than need Western peacekeepers — but that doesn't play so well on TV.

Couldn't agree more. The opportunities for education, health, poverty alleviation and real economic development which accrue to an individual who has a place to go to the bathroom are worth contemplating. Also worth contemplating, considering the overall pessimism regarding the potential of sub-Saharan Africa to reach the Millennium Development Goals, is the contribution that the provision of safe drinking water and improved sanitation (viz. latrines) makes to each of the other Millennium Development Goals. Much research exists to quantify the positive impact that safe drinking water and improved sanitation have on the MDGs on maternal and child health, education, poverty alleviation, gender equality and environmental sustainability. Some of the most clear findings on this are here.