WASH Journalists handout on WASH and AIDS

AIDS patient in Nigeria

                                                                     By Babatope Babalobi

The challenges facing people living with HIV/AIDS (PLHIV) are numerous; lack of safe drinking water, appropriate sanitation and hygiene education are just a few. In countries where antiretroviral drug therapy is keeping PLHIV well enough to resist most other life-threatening opportunistic infections, they are still dying from diarrhea.

• Every year over 2.8 million people die from AIDS. Over 33 million people live with HIV, most in low- and middle-income countries including West Africa.

• Improved nutrition and food security reduces susceptibility to diseases, including HIV/AIDS.
• Proper nutrition is a key aspect to maintain the health of PLHIV taking antiretroviral drug therapy.

• Diarrhea blocks nutrient absorption creating a cycle of poor nutrition among PLHIV.
• People living with HIV/AIDS and others with compromised immune systems, are more prone to common illnesses and diseases such as diarrhea. As such, access to improved sanitation and water supply is essential to the overall health of people living with HIV/AIDS.
• Opportunistic infections, resulting from water and sanitation related diseases and immune suppression in people living with HIV can accelerate the progression of HIV to AIDS. The frequency of those infections is closely tied to the level of water and sanitation services available to households affected by HIV/AIDS as well as the hygiene practices of household members.
• Diarrheal disease and various types of skin diseases are common secondary (or ‘opportunistic’) infections.[
• Households caring for PLHIV with advanced illness may also require a greater quantity of water than other households for medicines, bathing and laundry. This adds to the existing burden on caregivers to collect water

Solutions that work

• Improved water supply and sanitation reduces susceptibility to and severity of HIV/AIDS and other major diseases.

• Providing access to a safe, reliable and sufficient water supply and basic sanitation is essential for both the people living with HIV/AIDS and their caretakers who are often relatives, friends and neighbors.

• Improved access to a sustainable water supply lessens the risk of sexual violence, a risk factor for HIV, experienced during water collection.
• One study of people living with HIV/AIDS in Uganda found that the presence of a latrine reduced the risk of diarrheal disease by 31%.
• Water and sanitation services which are located in close proximity to HIV-affected households can have important labor saving effects, reducing the burden of caregiving and allowing more time for other activities, including school and income generation.
• Potable drinking water is often used to soften foods, making them more palatable for the chronically ill

Water and Sanitation vital in fight against AIDS, says experts

                                                                                      By Babatope Babalobi

The United Nations views  that  access to improved water supply and sanitation will improve the quality of life of people living with HIV/AIDS

Although HIV/AIDS is not a water-related disease, the issues are closely linked, says the United Nations World Water Development Report titled : “Water, a shared responsibility”.

Many of the opportunistic infections that kill people living with HIV/AIDS are transmitted through contaminated water and unsanitary living conditions.  once people are sick, they frequently suffer from diarrhea and require access to safe, sanitary latrines and large quantities of water for keeping themselves and their surroundings clean.

Improved water supply and sanitation can reduce the frequency of diarrhea.  The incidence of malaria can also be reduced when mosquito breeding areas caused by insufficient drainage are eliminated.

The UN report argues that there is a lack of research on the role the water sector plays for people living with HIV/AIDS.  Thus far, the disease has been treated as an epidemic and not considered a chronic disease or socio-economic problem. The emphasis, therefore is heavily placed on treatment and prevention.

Neither international organizations nor country governments have looked closely at the implications and potential contributions of the water sector in combating the disease and a remarkably small amount of academic research has been done on the subject.

A nearby and reliable supply of water, including for small-scale production and sanitary latrines, allows those infected by HIV/AIDS to continue productive activities and reduces the workload for caregivers. Due to lack of access to safe water for preparing infant formula, many HIV positive women breastfeed even though this exposes their babies to HIV.

If a reliable source of safe water and infant formula can be provided until the baby starts to eat solid foods at six months of age, the generational spread of the virus can be reduced.

The World Bank supported Water Supply and Sanitation programme is one leading organization that has established the link between water supply and sanitation and HIV/AIDS.

WSP-Africa recently engaged with partners to discuss  the strategic role of water in the alleviation of HIV/AIDS and Poverty.  At the Pretoria, South Africa Think Tank Meeting on 26-29 November, Senior Specialist Barbara Mwila Kazimbaya-Senkwe asked, “How can the Water Sector Improve Service Delivery to people living with HIV/AIDS in Africa’s Low Income Peri-Urban Areas?”.

 “It is necessary for the global HIV/AIDS community to work with the global water community to develop a consensus list of prioritized research needed on water and sanitation and HIV/AIDS,” said Dr. Kate Tulenko, a public health specialist of the Water and Sanitation Program.

 “With combined efforts of the AIDS and water communities, WaSH services can be offered to people living with HIV/AIDS to improve their health, relieve the caregiving burden, preserve human dignity, and fulfill the call for every sector to participate in the fight against HIV/AIDS”. 

People affected by HIV/AIDS are often marginalized by society and face extraordinary difficulties in accessing safe water and sanitation, while both is vital to their health.

Another global body- the Water Supply and Sanitation Collaborative Council (WSSCC)  promotes close linkages of WASH and HIV/AIDS sectors to increase dignity and well-being of infected people as well as their families.

According to a 2008 report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), 33.4 million people worldwide live with HIV and new infections now number 2.7 million annually. It is estimated that 2 million deaths occurred due to AIDS-related illnesses worldwide. Hundreds of millions more are affected through loss of parents, children, or colleagues.

Though a global pandemic, sub-Saharan Africa is most severely affected with 22.4 million HIV-positive people. South Asia and South-East Asia follow with 3.7 million infected. Poverty, including insufficient access to water supply and sanitation services, exacerbates the spread of HIV/AIDS; the highest burden of disease is found in regions with widespread poverty.

Diseases related to poverty, such as diarrhoeal and skin diseases, are the most common for people suffering from HIV/AIDS. Moreover, access to improved Water, Sanitation and Hygiene (WASH) services is also important for health and livelihoods in general, helping to prevent exposure to infection. These are clear reasons to facilitate the collaboration between the WASH and HIV/AIDS sectors.

Other cross-cutting issues include water quantity and quality and the training of family members, especially of caregivers, to support safe handling of water and maintaining hygienic conditions for those infected.