World Water Day Showcase: USAID’s Act to End NTDs | West Program Helps West African Countries Integrate WASH and NTDs
Washington, DC

As we mark the United Nations’ World Water Day today, we can’t help but notice that this year’s theme, “Leaving no one behind,” underscores an important commonality and connection between WASH and NTDs. Namely, that at least half of the people around the world who live without safe water — more than a billion people — suffer from one or more painful, debilitating NTD.

Without access to safe water, people are much more vulnerable to NTDs like schistosomiasis, soil-transmitted helminths, and trachoma, which disproportionately affect poor and rural populations, causing severe sickness and disability, compromised mental and physical development, childhood malnutrition, and reduced school enrollment and economic productivity.

Mass drug administration (MDA) is the first line of defense against these diseases, and USAID’s Act to End NTDs | West Program (Act|West), managed by FHI 360, is helping 11 West African countries to use MDA (which also relies on access to safe water, we should note!) to eliminate NTDs like lymphatic filariasis (LF), trachoma, and onchocerciasis.

Compulsory handwashing before entering the compound of the District Health team in Bo, Sierra Leone. Photo credit: Helen Keller International


But given current in-country environmental conditions, it’s not yet possible to eliminate some NTDs, such as schistosomiasis (SCH) and soil-transmitted helminths (STH), through MDA alone. That’s because, without access to clean water, sanitation, and hygiene, reinfections are commonplace, even when people are given medicines every year to treat these diseases.

WASH is so important for NTD control that the World Health Organization recently published a step-by-step, ‘how-to’ toolkit to help NTD program managers and partners engage and work with the WASH community for NTD control.

USAID’s NTD program has been actively working toward NTD and WASH integration for years. In 2013, USAID engaged the WASHplus Project, managed by FHI 360, to design and implement a pilot integrated WASH-NTD program model in Burkina Faso that implementing partners could scale up, adapt and replicate in other countries. In addition to promoting coordination among relevant government sectors, the WASHplus pilot developed a toolkit on WASH-NTD integration, based on its experiences in Burkina Faso and global partners and shared its experience and lessons learned with partners interested in advancing this work.

A girl drinks water after taking NTD prevention medicine in Niger girl water. Photo credit: Helen Keller Intl
A girl drinks water after taking NTD prevention medicine in Niger girl water. Photo credit: Helen Keller International

Launched in July 2018, the Act|West program aims to take NTD-WASH integration a step further, harnessing partner World Vision’s innovative WASH UP! model to help children (and their families) to learn and practice disease-preventing safe water, sanitation and hygiene habits.

WASH UP! began in 2015, the product of a partnership between World Vision and Sesame Workshop, the nonprofit educational organization behind Sesame Street, the popular children’s television show. Now used in 11 countries around the world, WASH UP! communicates messages about clean water, hand washing with soap, and proper latrine use, through videos, games, play mats, books, and songs, all featuring a vibrant 6-year-old Muppet named Raya and her friend Elmo. As part of the Act|West program, new materials will be created and utilized to more strongly connect the WASH messages already in the curriculum to the prevention of NTDs.

Ministries of health and educators in several African countries have also adopted WASH UP!’s school-based curriculum, which helps school children learn critical behaviors such as handwashing, wearing sandals to go to the latrine, and safe water storage. The initiative engages children through in-school, after school, and community-based programs with learning materials and educator’s guides that are contextualized for the participating schools and communities. It also encourages children to take these healthy habits home to their parents and siblings, increasing the program’s impact.

Given the importance of practicing good WASH habits for NTD control and prevention, the Act|West Program plans to scale up WASH education, such as the WASH UP! model, in five countries — Ghana, Mali, Niger, Senegal and Sierra Leone — over the next five years. By utilizing WASH UP! in West Africa, Act | West program partners are truly taking the 2019 World Water Day theme to heart, making every effort to “leave no one behind.”