Hygiene, Sanitation, and Water: Forgotten Foundations of Health

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1 Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, United States of America, 2 London School of Hygiene & Tropical Medicine, London, United KingomJamie Bartram¹, Sandy Cairncross^2*

Citation: Bartram J, Cairncross S (2010) Hygiene, Sanitation, and Water: Forgotten Foundations of Health. PLoS Med 7(11): e1000367. doi:10.1371/journal.pmed.1000367

Published: November 9, 2010

Copyright: © 2010 Bartram, Cairncross. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Funding: While writing this article, JB was a staff member of WHO, and SC was supported by the Higher Education Funding Council for England and by the Department for International Development (DFID). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: SC leads a UK Department for International Development-funded research programme consortium for research in sanitation and hygiene.

Abbreviations: DALY, disability-adjusted life year; GDP, gross domestic product; HSW, hygiene, sanitation, and water supply; MDG, Millennium Development Goal; ORT, oral rehydration therapy; PRSP, Poverty Reduction Strategic Plan

* E-mail: sandy.cairncross@lshtm.ac.uk

Provenance: Not commissioned; externally peer reviewed.

Summary Points

• 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./.../