The Council of Science Editors has organized 235 journals from 37 countries are publishing more than 750 articles on poverty and human development this week. For its theme issue, PLoS Medicine asked a variety of commentators from around the world to name the single intervention that they think would improve the health of those living on less than $1 per day. While reading the article, I was struck by three themes that emerged in multiple responses:
Water and sanitation – Several respondents identified improved access to clean water and sanitation as a high-impact intervention. Sanjeev Krishna (Professor of Molecular Parasitology and Medicine, St. George’s Hospital Medical School, London) stressed that safe water is a human right, while S.V. Subramanian (Associate Professor, Department of Society, Human Development and Health, Harvard School of Public Health, Cambridge, Massachusetts) pointed out that “ensuring adequate and equitable access to clean water and sanitation is likely to yield the greatest health dividend for the world’s poor,” and provide health benefits to the non-poor, too. Helene Gayle (President and CEO, Care USA, Atlanta, Georgia) recounted the example of a rural Bangladeshi community where installation of pit latrines led to a decline in diarrheal disease, which in turn affected under-five mortality and children’s school attendance.
Food security and nutrition – Mushtaque Chowdhury (Director of Research and Evaluation Division of Bangladesh Rural Advancement Committee, Dhaka) identified two square meals a day as the most effective intervention for health improvement, while Sallo Munro (Medical Research Council of South Africa, Health Systems Research Unit, Cape Town) focused ensuring that poor people get adequate nutrition to improve their immunity and keep diseases like tuberculosis at bay. Murugi Murekio (Reporter and Editor, Focus on Health, Poverty Reduction, Sustainable Development, Women and Children, Addis Ababa) noted that in Ethiopia, “antiretrovirals are free, but most women can barely afford a meal a day and so this diminishes their capacity to live healthily with HIV because they have no food.”
Focus on Women – “Education of women has been consistently shown to have a major impact on a number of health conditions,” says R. Srinivasa Murthy (Office of the World Health Organization Representative in Sudan, Mental Health, Khartoum). Rosebell Kagumire (Reporter, Focus on Health and Human Rights, NTV Uganda, Kampala) notes that “an educated woman will know what her child needs to eat for nutritional purposes and her income level is mostly higher than that of illiterate mothers.” Geeta Rao Gupta (President of the International Center for Research on Women, Washington, DC) recommends expanding savings and credit for women so they have access to emergency funds to pay for treatment of catastrophic illnesses.