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World Water Day 2023: Building the Investment Case for WASH in Health


Water, sanitation, and hygiene (WASH) are fundamental human rights and essential components to achieving the 2030 Sustainable Development Goals (SDGs), including SDG3: Good Health and Well-being and SDG6: Clean Water and Sanitation. However, globally, 2.2 billion people still do not have safely managed drinking water services, 4.2 billion people lack access to safely managed sanitation services, and 3 billion lack basic handwashing facilities.


The significant lack of WASH infrastructure globally not only has profound impacts on quality of life for affected communities, but represents a significant economic burden, both in health care utilisation and reduced productivity. Notably, communities with insufficient WASH are at increased risk of a host of communicable diseases, such as cholera, hepatitis A, typhoid, and a number of neglected tropical diseases, which exacerbate cycles of poor health and poverty among many of the world’s most marginalised communities.


To achieve SDG targets for WASH and health, increased advocacy is urgently needed to highlight the cross-cutting benefits of WASH investments. This will require health stakeholders to work more closely with WASH stakeholders to develop compelling investment cases that mobilise resources for integrated programs that address both WASH and health. Although this will require increased upfront investments, it will have long term gains by reducing disease prevalence and sustaining progress made from pharmaceutical interventions.


A policy window for change could emerge if there is strong public perception over the necessity of WASH, continuing advocacy with feasible and incremental policy proposals, and recognition of WASH as a key public agenda that requires government action. Yet, this scenario resembles the chicken or the egg situation – as one uses data and analysis to move political will of decision makers, their support in research production is fundamental.


The COVID-19 pandemic provides some opportunity to increase political will and mobilise resources toward those ends. Notably, the pandemic has reshaped the public perception over hand hygiene and emphasized the interconnectedness of environmental and human health. Leveraging this will be important to mainstream cross-sectoral collaboration at the heart of global health programs.


Going forward, the local capacities of research and routine data collection should also be strengthened to ensure self-sufficiency in scientific production and facilitate cross-sectoral collaboration. Systematic data collection will be critical to evaluate patterns and trends of WASH, while research questions should keep sight of long-term societal benefits. As such, investment in IT infrastructure and academic trainings is essential to keep track of WASH services. Training materials and “how-to” guides, such as OpenWHO and WASH Accounts, are also available to assist the development of local scientific capacity and monitor the performance of WASH services.


This World Water Day, Triangulate Health is joining global stakeholders in calling for increased collaboration across sectors to accelerate the process of resolving the water and sanitation crisis. Although there have been meaningful accomplishments in WASH, multi-sectoral collaboration must intensify to enhance knowledge sharing, conduct comprehensive research, and ultimately transform evidence into policies that truly benefit everyone.




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