Utilizing water for disease prevention: Looking for sustainable solutions

Poverty is often rooted in people’s environments. Geographic remoteness and limited access to markets significantly affect individuals’ opportunities to generate income and achieve social mobility.

In many regions, access to clean water remains a major challenge. With climate change exacerbating water scarcity, communities already experiencing water stress are expected to suffer even more in the future. As several days ago we marked World Water Day, I would like to highlight the critical link between water and public health.

A lack of clean water and proper sanitation leads to the spread of waterborne diseases, disproportionately affecting the poor. Many neglected tropical diseases (NTDs) thrive in areas with inadequate water, sanitation, and hygiene (WASH) facilities. For example, water contaminated with feces and urine can contain parasitic worm eggs that cause schistosomiasis and soil-transmitted helminthiasis (intestinal worms). Poor sanitation exacerbates infections, negatively impacting children’s development. It is estimated that 65% of Ethiopia’s population is at risk of infection by at least one NTD.

The most common approach to addressing NTDs in affected communities is through Mass Drug Administration (MDA) campaigns, which provide medications to treat these diseases. Often, pharmaceutical companies supply these drugs for free, and local governments distribute them to the population. However, despite these efforts, the diseases decline but resurge again with time, resulting in sustained high  prevalence. While treating infected individuals is essential, it does not address the root causes of the problem.

We must shift from treatment to prevention.

It is ironic to think that something as simple as face washing or using soap can significantly reduce disease transmission. For instance, face washing can lower the risk of trachoma transmission by up to 60%. Improved WASH facilities and practices, such as regular handwashing with soap, help reduce the spread of disease-causing bacteria.

For this to be effective, reliable water access is essential. However, in communities unaccustomed to consistent water availability, behavioral change support is necessary. A combination of improved water access and community engagement can lead to the sustainable elimination of diseases.

This is why I deeply appreciate the work of NALA, a global public health organization based in Israel that operates in Ethiopia and the wider region to combat NTDs. NALA focuses on disease prevention by designing adaptable, community-driven models, achieving a 90% reduction in illness prevalence in endemic communities over time.

To improve water access, NALA developed WASH on Wheels, a mobile unit operated by skilled technicians equipped to repair and restore water systems in remote schools. According to UNICEF, 546 million children worldwide attend schools with inadequate or non-existent water access, with 246 million suffering due to non-functional water infrastructure.

NALA trains local officials to repair and maintain school water infrastructure at an affordable cost while ensuring the long-term quality of water sources. Enhanced water access in schools contributes to disease reduction, improves educational outcomes, and strengthens children’s quality of life.

To drive behavioral change, NALA created tailored, community-led educational tools designed to promote preventive practices. These resources are implemented in schools, women’s groups, and school WASH clubs, which NALA helps establish. Model students and staff advocate for good hygiene habits, ensuring consistent handwashing facility use and helping to prevent diseases linked to poverty.

Finally, NALA builds strategic partnerships with governments, NGOs, and local communities to foster collaborative planning and resource sharing. By working alongside Ministries of Health, NALA scales these initiatives nationally and integrates them into long-term public health policies.

At a time when international aid budgets are shrinking and humanitarian assistance is increasingly prioritized over long-term development, it is crucial to think strategically and sustainably. While medications remain necessary for treating diseases, true public health improvements in developing countries will come from strengthening disease prevention capacities. If we are to ensure that children everywhere grow up healthy, receive an education, and have better opportunities than their parents, we must invest in local capacity-building, improved water infrastructure, and the promotion of preventive health behaviors.

Credit: NALA Foundation