Water, Sanitation & Hygiene

For Neglected Tropical Disease


About WASH and NTDs

What are the Neglected Tropical Diseases?

The neglected tropical diseases (NTDs) are a group of infections that put over two billion people at risk around the world. Though the NTDs are not often fatal, they cause chronic illness, pain, and disability. NTDs occur in areas with limited access to water and sanitation, and where hygiene practices, household infrastructure and health services are limited. These diseases are called “neglected” because they receive less attention and fewer resources than diseases such as HIV/AIDs, malaria, and tuberculosis. NTDs are also diseases of neglected people--the majority of people at risk of infection live in the poorest regions of the world.

Impact on Health and Development

Collectively, the NTDs cause blindness, disability, malnutrition and anemia, stunted growth, social stigma, and chronic pain. As a result of these impacts on health, NTDs contribute to an ongoing cycle of poverty and stigma that leaves people unable to work, go to school, or participate in family and community life.

WASH for the Neglected Tropical Diseases

Sustainable water, sanitation, and hygiene (WASH) services are essential for the prevention, long-term control, and even elimination of five of the NTDs: soil-transmitted helminthiasis (STH), trachoma, schistosomiasis, lymphatic filariasis (LF), and Guinea worm. Reducing levels of these WASH-preventable NTDs not only improves health and alleviates suffering, but can also lead to improved educational outcomes for children and increased economic progress for communities and nations. The WASH sector can significantly impact health and development by targeting WASH activities to areas where NTDs occur at the highest rates, and by incorporating behavior change messages relevant to specific NTDs into existing hygiene promotion efforts.

Cross-Sectoral Collaboration for WASH and NTDs

There is strong global momentum toward control and elimination of NTDs following the 2012 London Declaration, which established control and elimination targets by the year 2020. The pharmaceutical industry has pledged to help meet these targets through the donation of drugs to treat many of the NTDs to country governments. WASH organizations and programs can capitalize on this momentum by highlighting WASH impact on the NTDs, and engaging in advocacy opportunities with the NTD control sector to elevate global interest and public investment in WASH as a vital component of disease control. Collaboration between the WASH and NTD sectors can benefit both sectors, and the communities they serve.

About this Website

This website is intended to house information and resources that can help WASH practitioners to target and measure impact on the NTDs. Country-specific versions of WASH and the NTDs: A Manual for WASH Implementers can be accessed using the drop-down menu. Country pages also contain NTD maps, disease prevalence estimates in country, and links to additional resources. Click here to access all manuals on one page.

How to Use the Manual

WASH and the NTDs: A Manual for WASH Implementers is meant to be a practical guide for WASH practitioners working to implement, support, and sustain WASH interventions at the country level. These manuals will equip WASH-implementing organizations with the knowledge they need to target their interventions to NTD-vulnerable communities; to engage in and promote collaborative monitoring for NTD-specific health outcomes; and to communicate the impact of WASH on the NTDs for the purposes of advocacy and policy change.

WASH Interventions for Integrated NTD Control

A single WASH intervention can impact multiple NTDs. The table below shows how water and sanitation interventions can be implemented to target multiple diseases.

Type of intervention Specific intervention Diseases Impacted
Water Increasing access to sufficient amounts of safe water for personal hygienic purposes (e.g., washing hands, face or body; bathing; laundry) Soil-transmitted helminthiasis, schistosomiasis, trachoma, lymphatic filariasis, guinea worm disease
  Increasing access to sufficient amounts of safe water for environmental sanitation (e.g., cleaning latrines) Soil-transmitted helminthiasis, schistosomiasis, trachoma
  Increasing access to safe water for drinking / food preparation Guinea worm disease, soil transmitted helminths
  Monitoring impact of water resource development, waste water management and sanitation programs on vector breeding levels Schistosomiasis, lymphatic filariasis
Sanitation Reducing open defecation Soil-transmitted helminthiasis, schistosomiasis, trachoma
  Proper disposal of infant/child feces Soil-transmitted helminthiasis, schistosomiasis, trachoma
  Increasing improved sanitation coverage Soil-transmitted helminthiasis, schistosomiasis, trachoma
  Promoting maintenance and cleaning of latrines Soil-transmitted helminthiasis, schistosomiasis, trachoma

WASH hygiene messages

Specific hygiene messages for prevention and management of NTDs can be integrated into existing hygiene education at little to no cost. The table below summarizes NTD-specific hygiene messaging.

Type of intervention WASH Messages
Emphasizing the importance of:
Diseases Impacted
Hygiene Hand washing Soil-transmitted helminthiasis
  Face washing Trachoma
  Wearing shoes outside Soil-transmitted helminthiasis
  Daily washing, with soap, of swollen limbs, feet, and between toes to prevent bacterial infections Lymphatic filariasis
  Washing of soiled clothing/bedding Trachoma
  Avoiding physical contact with contaminated surface water Schistosomiasis
  Use of safe water for bathing, clothes washing, and swimming Schistosomiasis
  Avoiding physical contact with or entering bodies of water used for drinking Guinea worm disease

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Sightsavers UK AID International Trachoma Initiative
Children Without Worms WaterAid WASH Advocates Emory University - Center for Global Safe Water CARE