1. WASH Cluster – Emergency Training D D1 1 WASH Related Diseases Session 1 The Environmental Burden of Disease

2. WASH Cluster – Emergency Training D D1 2 Burden of Disease Question to group What is the current global burden of disease?

3. WASH Cluster – Emergency Training D D1 3 Burden of Disease Question to group For every 10 deaths worldwide how many would you classify as communicable disease related, non-communicable disease related and injuries?

4. WASH Cluster – Emergency Training D D1 4 Burden of Disease Out of every 10 deaths worldwide, 6 are due to non communicable conditions 3 to communicable, reproductive or nutritional conditions and 1 to injuries Source: World Health Statistics 2009, WHO

5. WASH Cluster – Emergency Training D D1 5 Environmental Burden “In children under the age of five, one third of all disease is caused by environmental factors such as unsafe water and air pollution” “Every year; the lives of four million children under 5 years – mostly in developing countries could be saved by preventing environmental risks such as unsafe water and polluted air” Source: WHO http://www.who.int/features/factfiles/environmental _health/en/index.html

6. WASH Cluster – Emergency Training D D1 6 Environmental Burden of Disease Question to group Of the Environmental/WASH related diseases which diseases account for the greatest burden?

7. WASH Cluster – Emergency Training D D1 7 0 1% 2% 3% 4% 5% 6% Environmental fraction Non-environmental Diarrhoea Lower resp. infections Other unintentional inj. Malaria Road traffic injuries COPD Perinatal conditions Ischaemic heart dis. Childhood cluster Lead-caused MMR Drownings HIV/AIDS Diseases with largest environmental contributions (I) % of global disease burden in DALYs Source: WHO

8. WASH Cluster – Emergency Training D D1 8 Prüss-Üstün, A. and Corvalán C., Healthy Environments, Towards an estimate of the environmental burden of disease, WHO, 2006

9. WASH Cluster – Emergency Training D D1 9 The Burden of Disease Burden of disease: the headlines –1.9 million attributable annual deaths from diarrhoea –1.2 million malaria deaths each year Burden of disease: the details –1.4 million preventable child deaths from diarrhoea –860 000 preventable child deaths from malnutrition –One third of the world population (2 billion infections) affected by intestinal parasitic worms –25 million people seriously incapacitated by lymphatic filariasis –200 million people with preventable schistosomiasis infections –5 million people visually impaired by trachoma –280 000 preventable deaths from drowning Source: Adapted from WHO

10. WASH Cluster – Emergency Training D D1 10 Under 5’s In the under 5’s what are the key causes of death?

11. WASH Cluster – Emergency Training D D1 11 New evidence showing that HWWS can reduce ARI’s by up to 23% 35% attributable to malnutrition New evidence showing that maternal HWWS can reduce neonatal mortality by 44% Clear association between undernutrition and intestinal infections Source:Therese Dooley, UNICEF, World Water Day Conference, Dublin, March 09

12. WASH Cluster – Emergency Training D D1 12 Mortality in the Under 5’s Africa Region Neonatal – 21% HIV/AIDS – 5.0% Diarrhoea – 16.3% Measles – 3.9% Malaria – 15.6% Pneumonia – 20.4% Injuries – 2.4% Other – 15.4% SE Asia Region Neonatal – 39% HIV/AIDS – 0.4% Diarrhoea – 19.5% Measles – 5.5% Malaria – 0.4% Pneumonia – 13.7% Injuries – 5.3% Others – 16.2% Source: World Health Statistics 2009, WHO