Controlling water-borne diseases

The prevention, control and reduction of water-related disease are important and urgent tasks which can only be satisfactorily discharged by enhanced cooperation at all levels and among all sectors, both within countries and between States.

Particularly in rural tropical areas, people come in daily contact with water for a variety of reasons: drinking, bathing, washing clothes, and crossing on foot. Such frequent contact with water can lead to infection by water-borne parasites, especially where unsanitary practices, such as indiscriminate defaecation, prevail.

Cholera, typhoid fever and hepatitis A are water-related diseases often associated with developing countries or perhaps medieval Europe. Yet at the dawn of the third millennium, these diseases are making a comeback in some European countries. In the past decade there have been some 190 outbreaks of bacterial dysentery, 70 outbreaks of hepatitis A and 45 outbreaks of typhoid fever associated with drinking-water and recreational water in Europe and central Asia.

Waterborne infectious diseases are the second largest category of communicable diseases contributing to infant mortality worldwide. WHO has estimated that in 1996, some 2.5 million people died of diarrhoea, most of whom were children under the age of five years. In addition, there are other water-related risks that are of special relevance to children, such as the risk of methaemoglobinaemia from nitrate contamination.

This strategy features in the framework of Agenda 21 as formulated at UNCED (Rio de Janeiro, 1992), now coordinated by the United Nations Commission on Sustainable Development and implemented through national and local authorities.

The Protocol on Water and Health of the UN/ECE Convention on the Protection and Use of Transboundary Watercourses and International Lakes should help countries to reduce such outbreaks by providing safe drinking-water and recreational water to people throughout Europe. The Protocol has been drawn up under the auspices of UN/ECE and the WHO Regional Office for Europe. Its ultimate aim is to reduce, control and prevent water-related disease. It is expected to be signed at the Third Ministerial Conference on Environment and Health in London on 16-18 June 1999.

Article 4(5) of the Draft Protocol on Water and Health (1999) to the Convention on the Protection and Use of Transboundary Watercourses and International Lakes (1992), requires that: The Parties shall take all appropriate action to create legal, administrative and economic frameworks which are stable and enabling and within which the public, private and voluntary sectors can each make its contribution to improving water management for the purpose of preventing, controlling and reducing water-related disease.

Article 5(e) of the Draft Protocol on Water and Health (1999), states: Preventive action should be taken to avoid outbreaks and incidents of water-related disease and to protect water resources used as sources of drinking water because such action addresses the harm more efficiently and can be more cost-effective than remedial action.