The importance of access to safe drinking water, sanitation, and hygiene (WASH) facilities in reducing the cholera burden in low- and middle-income countries (LMICs) has been highlighted in a new study. Published in the KeAi journal Global Transitions, the research evaluates the impact of WASH access on cholera across 89 LMICs from 2000 to 2017, under the framework of the United Nations Sustainable Development Goals (UNSDG). The findings reveal that improved WASH facilities, such as piped water and sewer/septic sanitation, have protective effects against cholera, whereas unimproved facilities, like surface water and open defecation, exacerbate the risk.

Cholera remains a persistent health threat in LMICs, with the Global Task Force on Cholera Control (GTFCC) aiming to reduce cholera-related deaths by 90% and eliminate the disease in up to 20 countries by 2030. The study’s lead author, Wanqi Wen from Sun Yat-sen University, emphasizes that safe WASH access is the only long-term and sustainable solution for cholera prevention and control. The research provides crucial data for cholera-affected areas to develop targeted control strategies, as outlined in the GTFCC’s Global Roadmap.

The study also sheds light on the regional disparities in WASH access and their contribution to the unequal cholera burden. For instance, in Sub-Saharan Africa, 25.77% of cholera cases were attributed to the high proportion of unimproved drinking water, significantly higher than the 9.09% in Northern Africa and Western Asia. Corresponding author Hualiang Lin points out that achieving universal access to improved sanitation could reduce cholera risk by 32.98% in Sub-Saharan Africa, compared to 7.47% in Central and Southern Asia.

This research not only underscores the critical need for maintaining and increasing access to safe WASH in cholera-affected countries but also offers actionable insights for implementing UN SDG 6 and the GTFCC’s 2030 Roadmap. The authors advocate for scaling up safe WASH access as a core requirement for eliminating cholera globally, highlighting the intersection of public health and sustainable development goals.

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