Making water truly safe: WASH and the risk of vector-borne diseases in urban settings

The MENTOR Initiative urge immediate action to integrate disease control with water and sanitation, as the UN 2023 Water Conference gets underway today (22 March) to address the global water agenda. Otherwise, many millions of people living in densely populated urban settings are at risk of death and suffering from vector-borne diseases.

Richard Allan, MENTOR Chief Executive, issues a stark message that without a robust, co-ordinated policy to improve access to water that is truly safe, we face one of the greatest threats to global health. He explains why:

“Three species of mosquitoes, responsible for transmitting major viral diseases like malaria and dengue fever, breed and proliferate in water sources – either clean, containerised water or wastewater. One of these species, Anopheles Stephensi, an invasive vector that transmits malarial parasites, breeds in both clean and wastewater.

“In impoverished, urban settings, containers are primarily used for water storage due to lack of reliable piped water. Sanitation, hygiene and waste removal systems are poorly resourced and overburdened. Added to this is rapid, unplanned urbanisation, an increase in displaced people, and a large immunologically susceptible population. Together, these factors make it highly likely a transmission surge will occur, which poses a major challenge to malaria control. Global cases of malaria threaten to expand significantly, year on year, and may overwhelm already overstretched health services.

“These same conditions allow filth flies to transmit many pathogens from E-coli to cholera. So, we have to recognise how to make water properly safe to prevent the most harmful diseases and protect people, especially young children who are most vulnerable.”

In a recent Lancet article, Richard and his co-authors present how dengue control activities can be replicated to control malaria transmitted by A stephensi in urban settings. Solutions include improving water storage and waste container disposal, introducing piped water and controlling domestic waste. In other words, safely managing services to avoid creating breeding sites for disease vectors.

Richard said: “Vector control is integrally linked to concepts of environmental hygiene and targets of the WASH sector. Integrating these interventions could be transformative in our ability to target multiple diseases, which is particularly pertinent in fragile settings where diseases are likely to co-exist.

“Overcoming disconnected thinking and involving all relevant organisations from health, WASH, shelter and education to work together across different settings and outcomes is how we can bring these diseases under control.

“MENTOR is in position to support and inform improved policy and practices that guarantee truly safe water – for life.”