Access to clean water and basic toilets is an essential but
neglected part of the management and treatment of human immunodeficiency virus
(HIV), new research by international development organisations WaterAid and
SAfAIDS has found.
The new report shows that 70% of the approximately 35
million people people living with HIV in the world reside in Sub-Saharan
Africa. This equates to approximately 25 million people.
Clean water is critical to keeping people living with HIV
healthy, for taking antiretroviral (ARV) drugs and for the good hygiene
required to minimise infections. Yet 35% of people in Sub-Saharan Africa are
living without access to clean water and 70.4% are without basic sanitation.
This leaves many people living with HIV suffering from chronic diarrhoea and
unable to care for themselves or their families.
Diarrhoea compromises the effectiveness of ARV drugs by
reducing the body’s ability to absorb nutrients from food and medicine. Many
life-threatening opportunistic infections are caused by exposure to unsafe
drinking water, inadequate sanitation, and poor hygiene. Diarrhoea is a very
common symptom that can occur throughout the course of HIV and AIDS and affects
90% of PLHIV resulting in significant morbidity and mortality. 88% of
diarrhoeal cases are directly linked to unsafe drinking water, inadequate
sanitation and poor hygiene.
Also read: Lagos promotes testing, treatment of HIV/AIDS
Dr. Michael Ojo, WaterAid Nigeria Country Representative,
“Thanks to the great strides in medical research over the
last three decades, HIV is now a much more manageable condition and no longer
the death sentence it used to be. It seems to be counter-productive that in
spite of such progress on education and in delivering anti-retroviral drugs,
there’s no focus on ensuring people living with HIV/AIDS also have clean water,
basic toilets and the means to wash themselves and keep their surroundings
These basic services are crucial in helping those living
with the illness to lead healthier, more dignified and more productive lives.”
Lack of access to clean water nearby means many households
have more than a kilometre to walk for water, and people living in households
without toilets, including the sick and elderly, have no choice but to defecate
in the bush.
Taking ARV drugs requires 1.5 litres of safe, clean water
each day. However, a person living with HIV might require up to 100 litres a
day to stay clean and healthy. This takes into account basic needs for
drinking, food preparation, laundry and washing, as well as for formula-feeding
babies born to mothers with HIV, for watering gardens to improve nutrition, and
for extra cleaning, washing and laundering during cases of diarrhoea. In many
parts of Sub-Saharan Africa, this is simply not possible.
The report recommends combining water, sanitation and
hygiene into HIV services to recognise that without sufficient clean water,
sanitation and proper hygiene, people living with HIV will be more ill more
often, and less able to live healthy and productive lives.
Lois Chingandu, SAfAIDS Executive Director, said:
“If the world does not prioritise water and sanitation
hygiene issues, all gains made in the HIV response will be reversed. Concerted
efforts must be made to ensure the existing linkages are given the attention
and prominence they deserve.”
With less than a year until UN member states agree the new
Sustainable Development Goals (SDGs), WaterAid and sector partners are calling
for a stand-alone goal on water and sanitation. Universal access to water,
sanitation and hygiene services, already recommended in the initial draft, will
play a critical role in supporting health targets such as eliminating AIDS by
WaterAid also calls for proposals around universal health
coverage to include environmental factors such as water, basic toilets and good
hygiene education within households. For people living with HIV, this would
help to prevent opportunistic infections and enable healthier, more productive
It is important that we continue to highlight the challenges
facing those living with HIV and AIDS and to ensure their needs and rights
remain high on the global agenda and we’re hoping our new report, An
integrated approach to HIV and water, sanitation and hygiene in Southern
Africa: A gap and needs assessment, will hopefully make a significant
contribution to the on-going debate and lead to real action.
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