Study Reveals Critical Link Between WASH Access and Cholera in Low- and Middle-Income Countries

A groundbreaking study has shed light on the pivotal role of water, sanitation, and hygiene (WASH) access in combating cholera across 89 low- and middle-income countries. Published in the KeAi journal Global Transitions, the research underscores the protective effects of improved WASH facilities, such as piped water, against cholera, while highlighting the detrimental impact of unimproved facilities like open defecation.

The study, conducted under the framework of the United Nations Sustainable Development Goals (UNSDG), aligns with the Global Task Force on Cholera Control's (GTFCC) ambitious strategy to reduce cholera-related deaths by 90% and eliminate the disease in up to 20 countries by 2030. The findings reveal that disparities in WASH access contribute significantly to the unequal cholera burden observed across different regions, with Sub-Saharan Africa bearing the highest proportion of cholera cases attributed to unimproved drinking water.

Wanqi Wen, the study's first author from Sun Yat-sen University, emphasizes that safe WASH facilities are the cornerstone of long-term cholera prevention and control. The research provides valuable insights for cholera-affected regions to develop targeted strategies, as advocated by the GTFCC's Global Roadmap. Notably, the study identifies piped water and sewer/septic sanitation as key factors in reducing cholera risk, whereas surface water and open defecation exacerbate the problem.

Hualiang Lin, the corresponding author, points out the stark regional disparities in WASH access and their implications for cholera prevention. The study estimates that achieving universal access to improved sanitation could significantly reduce cholera risk, particularly in Sub-Saharan Africa, where the potential reduction is as high as 32.98%. These findings offer a compelling case for scaling up safe WASH access as a fundamental step toward eliminating cholera globally.

The study's implications extend beyond public health, offering actionable data for policymakers and stakeholders working toward UN SDG 6 and the GTFCC's 2030 Roadmap. By highlighting the critical need for improved WASH facilities, the research underscores the intersection of development goals and health outcomes, presenting a clear path forward in the global fight against cholera.