June 13,2013

WASH and STH in the Americas

At last – Recognizing the Link between WASH and STH. Reflections on the importance of WASH for STH control in Latin America.

By William Lin, Director of Worldwide Corporate Contributions at Johnson & Johnson (cross-posted from InterAction.org)

The Pan-American Health Organization (PAHO) recently released a report on soil transmitted helminthes (STH) infection in the Americas and Caribbean, indicating that approximately 46 million children in that region alone are infected or at risk of infection by intestinal worms. That is close to a quarter of all the children living in that region. It is a staggering statistic when we consider that it is unacceptable for even one child here in the U.S. to be afflicted with parasites.

STH infections afflict those living primarily in areas lacking access to clean potable water or improved sanitation facilities – the package of services typically referred to as WASH (water, sanitation, and hygiene education). Approximately 32 million of those at risk in Latin America are school-age children. For any child STH infection is painful in the short term and devastating in the long term – it causes irreversible impairment in physical and cognitive growth, because the worms take hold in a child’s body and consume the vital nutrients needed for healthy development.

Three years ago Johnson & Johnson answered the UN Secretary General’s Call to Action for progress toward the Millennium Development Goals with a commitment to improve maternal and child health. This commitment included – among many other investments in maternal and child health – a quadrupling of the number of doses of deworming medicines given to children at greatest risk of STH infection.

PAHO, in collaboration with Children Without Worms, the Canadian International Development Agency (CIDA), and the Global Network on Neglected Tropical Diseases (GNNTD), recently convened a meeting in Bogota – the first regional convening to address the issue of STH infections in the Americas and the Caribbean. The meeting brought together stakeholders to discuss how to effectively and efficiently utilize donated medicines and to take approaches that will lead to sustained impact. Of the 23 countries identified as being endemic for STH, 18 attended.

This was an impressive turnout and the group was very engaged. From my vantage point, I see widespread recognition that in addition to the fact that STH is a big problem in the Americas, lack of access to clean water, improved sanitation, and proper hygiene (WASH) is a key contributor to STH transmission. This acknowledgement, by this sector, is vital – with WASH identified as a critical issue that is in need of attention, there is hope and potential for long-lasting approaches to stem the number of STH infections that occur each year. None of the participants were satisfied with administrating medicines as a stand-alone intervention. They realized both the need to relieve the suffering with medicines – as well as tackle the problem at the root cause.

Now that the meeting is over, individual country stakeholders must to go back to their respective corners to finalize their plans of action to mobilize resources and leverage the drug donations pledged by Johnson & Johnson and GSK at the London Declaration.

J&J has partnered with INMED Andes in Peru since 2008 to conduct deworming and nutritional and hygiene education campaigns through their Healthy Children, Healthy Futures platform. With a close collaboration with the regional government ministries of Health and Education, there were recent campaign launch activities in Ucayali and Huánuco. Programs in these two provinces will ultimately lead to treatment of up to 700,000 children each year. With this experience, INMED Andes is well-positioned to lend their experience to a successful rollout of a national program to systematically treat all the children of Peru at risk of STH infection.

UNICEF’s 2012 State of the World’s Children report shows that 93% of the population in Latin America and the Caribbean has access to clean water and 80% has access to improved sanitation. These are encouraging statistics as they imply that there are opportunities to make significant change in the status of STH infections and in many cases, be able to interrupt transmission.

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