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PLoS Medicine Policy Forum on Water and Sanitation

Below are links to the full-text of the 4 articles in the the water and sanitation policy series just published in PLoS Medicine:

1 – Bartram J, Cairncross S (2010)

Hygiene, Sanitation, and Water: Forgotten Foundations of Health.PLoS Med 7(11): e1000367. doi:10.1371/journal.pmed.1000367

A massive disease burden is associated with deficient hygiene, sanitation, and water supply and is largely preventable with proven, cost-effective interventions. The total benefits of these interventions are greater than the health benefits alone and can be valued at more than the costs of the interventions. Hygiene, sanitation, and water supply are development priorities, yet the ambition of international policy on drinking water and sanitation is inadequate. Hygiene, sanitation, and water supply continue to have health implications in the developed world. The active involvement of health professionals in hygiene, sanitation, and water supply is crucial to accelerating and consolidating progress for health.

2 – Hunter PR, MacDonald AM, Carter RC (2010)

Water Supply and Health. PLoS Med 7(11): e1000361. doi:10.1371/journal.pmed.1000361

A safe, reliable, affordable, and easily accessible water supply is essential for good health, but for several decades almost 1 billion people in developing countries have lacked access to such a supply. A poor water supply impacts health by causing acute infectious diarrhoea, repeat or chronic diarrhoea episodes, and nondiarrhoeal disease, which can arise from chemical species such as arsenic and fluoride. It can also affect health by limiting productivity and the maintenance of personal hygiene. Reasons for the limited progress towards universal access to an adequate water supply include high population growth rates in developing countries, insufficient rates of capital investment, difficulties in appropriately developing local water resources, and the ineffectiveness of institutions mandated to manage water supplies (in urban areas) or to support community management (in rural areas). Strenuous efforts must be made to improve access to safe and sustainable water supplies in developing countries, and, given the health burden on the public and the costs to the health system, health professionals should join with others in demanding accelerated progress towards global access to safe water.

3 – Mara D, Lane J, Scott B, Trouba D (2010)

Sanitation and HealthPLoS Med 7(11): e1000363. doi:10.1371/journal.pmed.1000363

2.6 billion people in the world lack adequate sanitation—the safe disposal of human excreta. Lack of sanitation contributes to about 10% of the global disease burden, causing mainly diarrhoeal diseases. In the past, government agencies have typically built sanitation infrastructure, but sanitation professionals are now concentrating on helping people to improve their own sanitation and to change their behaviour. Improved sanitation has significant impacts not only on health, but on social and economic development, particularly in developing countries. The health sector has a strong role to play in improving sanitation in developing countries through policy development and the implementation of sanitation programmes.

4 – Cairncross S, Bartram J, Cumming O, Brocklehurst C (2010)

Hygiene, Sanitation, and Water: What Needs to Be Done? PLoS Med 7(11): e1000365. doi:10.1371/journal.pmed.1000365

As the last article in a series on water and sanitation, this paper considers what needs to be done to make significant progress towards ensuring universal access to hygiene, sanitation, and water. We first discuss the differences between these three subsectors and the possible reasons for poor rates of progress towards achieving universal access in recent years. Then, we consider the actors whose engagement is essential for the sector, including the poor households themselves who are significant investors, local and central government, donors, and international agencies. Finally, we discuss the potentially important role of the health sector in improving hygiene, sanitation, and water worldwide and propose a detailed Agenda for Action.

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