POONAM KHETRAPAL SINGH

India, along with 11 member-countries of the World Health Organisation’s South-East Asia region, has made concerted efforts to provide water and sanitation infrastructure and services to everyone, everywhere. It’s expanding infrastructure like safe water points and designated latrines and services like sewage treatment and safe wastewater disposal.

Region-wide, the effort is paying off. In India, for example, inadequate water, sanitation and hygiene once had a dramatic effect on its disease burden. In 1990, at the start of the Millennium Development Goal era, poor sanitation was the second-largest cause of disease in the country. Thanks to a range of long-term initiatives that have since been intensified, water and sanitation is now the seventh-largest cause of disease, accounting for around 5% of the country’s disease burden. That is a substantial achievement — one that indicates the life-changing potential further progress holds.

The numbers are instructive. By 2015, 88% of the country’s citizens had access to improved drinking water and 44% had access to improved sanitation. The ‘Swachh Bharat Abhiyan’ (Clean India Campaign) introduced the same year has since then increased that proportion substantially, and will continue to do so as the mission moves towards its goal to end open defection and ensure every citizen has access to latrines by 2019.

But as elsewhere in the South East Asian region, despite progress, insufficient water and sanitation-related infrastructure remains a significant cause of life-threatening diseases. Diseases responsible for severe and often fatal diarrhoea. Diseases that impose malnutrition and stunting on millions of children and adolescents. Diseases that are both chronic and acute, and, which can cause liver failure, urinary tract infection and blindness. Diseases such as cholera and helminth (worm) infections, hepatitis, schistosomiasis and trachoma. Each