Cholera or No Cholera: Time to Decide

Cholera could be a thing of the past if leaders at this week’s World Health Assembly focus on improving access to sanitation and water in the world’s poorest countries.

International development agency WaterAid has made the plea to ensure that sanitation and water are prioritized in a resolution on controlling and preventing cholera , which is due to be discussed and approved at the Assembly in Geneva.
Cholera, a highly infectious Diarrhea disease and can be life-threatening, but the measures to prevent it are basic –access to safe drinking water and basic sanitation, accompanied by good hygiene practices.
While the World Health Organization has repeatedly stated that efforts to address cholera should be focused on improving water and sanitation, there has been a strong push for stricken countries to adopt the use of oral vaccines.

Water Aid warned that vaccines must not be the sole method of containing cholera but that they should be part of a comprehensive strategy to prevent the disease.

“The development of safe, effective and potentially affordable oral cholera vaccines is important, however it is imperative that this approach is complementary to, and should not substitute for, the existing effective prevention and control measures; particularly safe water and sanitation,” said Mustafa Talpur, Water Aid’s Policy Advisor for South Asia.  

WaterAid in South Asia reminded leaders that safe water and sanitation would not only help address cholera, but have far wider health benefits.

“We know how to prevent cholera, and now it’s up to governments to focus their efforts on ensuring we beat this disease once and for all. But this is not the only reward – the same measures can prevent other diarrhoeal diseases, which are responsible for a huge number of deaths across South Asia,” explained Mr. Talpur.

It’s not just cholera that kills – diarrhoea drains the body of water and salts necessary for survival. Most people who die from diarrhoea die from severe dehydration and fluid loss. Children under the age of five, particularly those who are malnourished or have impaired immunity, are most at risk of life-threatening diarrhoea, which is symptomatic of unsanitary living conditions.

In South Asia, nearly one billion people live without access to adequate sanitation and more than 700 million practice open defecation – exposing people to serious and potentially fatal health risks as a result.

Diarrhoeal diseases are the leading cause of child mortality in India, Nepal and Pakistan. In Bangladesh, it is the second leading cause of death in children under five years old, after pneumonia.

In 2009, an outbreak of diarrhoeal diseases in 20 districts of Nepal killed more than 346 people and affected 62,016 people. One district alone, Jajarkot, suffered 154 deaths. In India, at least 140 people died in similar circumstances in Orissa state in 2007.

“The World Health Assembly is a key opportunity to achieve real progress on public health through improving the way the health and water, sanitation and hygiene sectors interact,” Mr. Talpur continued. “It is the first time that a discussion on the role of water, sanitation and hygiene in health will be undertaken.