THE first decade of this century brought a surge in aid for health, particularly for HIV and malaria. Now health officials and wonks are debating how to fight a broader range of diseases. The World Bank has set a goal of universal health-coverage by 2030. This is an important, complex endeavour. But in the effort to improve health care, it is worth remembering a simple, albeit unsavoury truth: poo matters.
In the history of public health, few events are as important as a discovery made in the mid-19th century, not far from the site of The Economist’s London offices. A doctor named John Snow demonstrated that a contaminated water pump was helping to spread cholera. Subsequent investment in sewage systems helped banish the scourge from London and much of the world. Today proper water and sanitation systems are as crucial as ever to avoid crippling infectious diarrhoeal diseases, such as cholera and salmonellosis. Every dollar spent on sanitation brings a return of $5.50, in the form of lower health costs and improved productivity, according to the World Health Organisation.