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Global Health Econ Sustain Global South: Healthier lives with UVC

the Global South. For perspective, in 2022, just in a few these rates may be significantly underreported (Ekundayo
months, the number of individuals affected by drought- et al., 2021).
related water scarcity in Ethiopia, Kenya, and Somalia Of the 4.2 billion people (>half of the world’s
surged from 9.5 million to a staggering 16.2 million, population) who lack daily access to clean water, 673
exposing people to waterborne infections due to poor million practice open defecation (UNICEF, 2020), which
sanitary conditions (UNICEF, 2022). A recent study on is a significant contributor to waterborne pathogens. For
the impact of increasing extreme flood events in many instance, in Ghana, approximately 81% of the population
low- and middle-income countries (LMICs) found that employs inadequate or unimproved toilet facilities, and
severe floods, long-duration flooding, and floods preceded over 15% of households practice open defecation (Oppong
by drought, all often in conjunction with pre-existing et al., 2022). Microbial water contamination, often due to
poor WASH conditions, lead to a higher prevalence and fecal contamination, is the greatest overall risk to drinking
increased risk of diarrhea among children younger than water safety (WHO, 2022). Water, sanitation, and hygiene
age five (Wang et al., 2023).
conditions are fundamental to public health, socioeconomic
These waterborne diarrheal diseases disproportionately development, and quality of life (Hutton & Chase, 2017),
impact resource-limited regions such as those in the as they prevent waterborne diseases and infections such
Global South (Centers for Disease Control and Prevention, as cholera, typhoid, dysentery, polio, and other diarrheal
NCEZID, Division of Foodborne, Waterborne, and diseases. Poor WASH conditions can result from limited
Environmental Diseases, 2020; Fischer Walker et al., 2012). access to clean water, insufficient sanitation facilities and
Several studies across the Global South have identified the resources, and inadequate hygiene practices. Poor WASH
prevalence of waterborne diseases in contaminated water conditions are often directly linked to contaminated
sources. One study in Marigat, Kenya, a semi-arid area, water sources and deficient water purification practices
revealed that all drinking water collected from direct water (Centers for Disease Control and Prevention, NCEZIDs,
sources (e.g., rivers, wells, and boreholes) and at the point Division of Foodborne, Waterborne, and Environmental
of use (e.g., households, schools and health-care facilities) Diseases, 2020).
was microbially contaminated with E. coli, driving the
need for immediate public health action (Osiemo et al., 2.2. Impact on society
2019). In addition, Cryptosporidium spp. and Giardia spp. 2.2.1. Impact on public health
were found to be major parasitic contaminants in many
African and South Asian water sources (Squire & Ryan, While access to clean water is slowly increasing globally,
2017). In India, the prevalence of waterborne diseases eight out of ten people still lack the most basic access
among the vulnerable elderly population was higher in to clean water (UN DESA, 2022a; 2022b). In addition,
rural areas (22.5%) than in urban regions due to the lack global water demand is rapidly outpacing population
of access to clean water sources (Kumar et al., 2022). In growth, while climate change directly impacts consistent
Ecuador, indigenous populations, young children, and water availability in regions vulnerable to drought,
older adults were at the highest risk of hospitalization leading to severe water scarcity (Adams et al., 2020; UN
due to waterborne diseases, likely contributing to the DESA, 2022b). Those without basic access to clean water
dramatically lower life expectancy compared to other are disproportionately located in geographic areas with
ethnicities in the region (964 years of life lost per 100,000 limited access to clean water, such as the Global South.
people) (Ortiz-Prado et al., 2022). In 2012, five major rivers The Global South is experiencing rapid urbanization,
in Argentina were found to be heavily contaminated with exacerbating urban poverty, inequitable water security,
norovirus (Fernández et al., 2012), whereas, in Pakistan, and even the development of “water mafias.” For instance,
the prevalence of multidrug-resistant typhoid fever was urban poverty in Kenya has led to the development of the
widespread, primarily attributable to the intermingling Kibera and Mathare slums, two of the largest informal
of wastewater and drinking water systems (Rasheed et al., settlements in the capital city of Nairobi. Within these
2019). A systematic review and meta-analysis of global respective slums, approximately 77% and 61% of the
norovirus water contamination found that the water population face challenges accessing adequate WASH
contamination levels directly mirrored the incidence facilities (Kim et al., 2022). As an illustration, Figure 2
of gastroenteric and diarrheal diseases. In addition, shows an aerial view of Kibera, Kenya’s largest informal
publication bias in reporting lower incidence levels settlement situated in the capital city of Nairobi (Dims,
was posited to be the result of individual governmental 2023). In this settlement, nearly 200,000 residents grapple
reporting and water management policies, indicating that, with access to water or encounter prohibitive costs for
despite the concerning levels of global contamination, limited access. These limitations result in poor WASH

Volume 2 Issue 1 (2024) 4 https://doi.org/10.36922/ghes.1984