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NGOs Urge Renewed Fight Against Diarrheal Disease

Nearly two million children die each year from diarrheal diseases, which account for 17 percent of the deaths of children under five. Development advocates say much more can be done to reduce those numbers. But they say governments focus on other diseases that, while serious, kill fewer children than diarrheal illnesses. In May, two development organizations, WaterAid and PATH, both issued reports outlining the problem and calling for change.

Both NGOs want governments and donors to recognize the seriousness of diarrheal diseases and to increase financial support to reduce the problem.

They say between 2004 and 2006, only $1.5 billion was spent on sanitation measures that could curb outbreaks of diarrhea, while 10 times as much went to HIV/AIDS treatment. But experts say that many more children die of diarrheal diseases than AIDS.

Money spent on malaria was three times as high as funding for sanitation, though diarrheal illnesses kill twice as many children.

In another example, Rwanda has a 3% rate of HIV/AIDS infection, but in 2005 almost 75 % of donor assistance for health was for HIV/AIDS and two percent for childhood illnesses. Health specialists say that number is not very different today.

WaterAid and PATH have several recommendations.

They say the international aid system and developing governments must respond to evidence showing diarrheal diseases as one of the leading causes of child mortality, and they must target resources appropriately.

That means strengthening water and sanitation systems and taking other steps to prevent the problem, including breastfeeding and oral rehydration therapy. WaterAid and PATH also suggest the use of vaccines against the most common and lethal form of diarrheal diseases, rotavirus.

Nancy Bwalya-Mukumbuta is WaterAid's program manager in Zambia.

She says much of the government’s funding for anti-diarrheal measures goes to programs that treat the illnesses. But she says more money should go to the Environmental Health Department which works to prevent them.

Bwalya-Mukumbuta says it should teach the public better hygiene and other sanitation practices that can help prevent diarrheal illnesses including regular hand washing. But she says the department’s technicians are not doing a good job of instruction.

"Currently," she says, "these environmental health technicians are in rural health centers dispensing medicines and diagnosing disease rather than teaching good sanitation and hygiene to the community."

Bwalya-Mukumbuta suggests funding for the purchase of vehicles that will help the technicians reach deep into rural areas.

She also says better coordination is needed between various departments of the government.

"There is a need to coordinate across different sectors," she says.

"We have a Ministry of Local Government and Housing, which is responsible for water and sanitation delivery. They are not working closely with the Ministry of Health, which is responsible for disease prevention and treatment.

"We’d like to see an increase in collaboration among the ministries. We also want to see planning based on information coming out of the Health Management Information System…. We have a good health information management system in Zambia, which can be used for planning and budgeting purposes. So I definitely think this is how to respond to evidence and to the disease burden."

These two reports by WaterAid and PATH say neglecting sanitation undermines the effectiveness of current health systems. And health specialists warn that it sets back efforts by Africa to meet the UN Development Goals, which include cutting child mortality rates in half by 2015.