The importance of water, sanitation and hygiene for lymphatic filariasis and leprosy care and inclusion

The importance of water, sanitation and hygiene for lymphatic filariasis and leprosy care and inclusion

Lymphatic filariasis (LF) and leprosy are neglected tropical diseases (NTDs) representing a significant global burden of disease morbidity. Like most NTDs, LF and leprosy are most prevalent in poor, rural and marginalised populations. NTD prevalence is becoming known as a ‘proxy for poverty and disadvantage’. Although not commonly fatal, LF and leprosy both have devastating debilitating effects when left untreated. Both are treatable, yet millions of people around the world live with the consequences of permanent disability.

LF and leprosy are targeted for elimination by the World Health Organization (WHO). Global efforts to reduce the burden of disease have been guided by WHO targets for disease elimination. Roadmaps for eliminating LF and leprosy include strategies that identify guidelines for disease prevention, treatment, and morbidity management and disability prevention (MMDP).

A significant portion of disease burden associated with LF and leprosy are related to disability and deformity caused by disease. Therefore, to reach elimination targets and meet the needs of those affected by disease, strategies and programmes must have a strong focus on MMDP. Poor uptake of MMDP coupled with a lack of WASH consideration in MMDP strategy guidelines represents a significant barrier to improving the quality of life and health of infected individuals. Therefore, this paper aims to clearly identify the role of WASH for MMDP self-care, the WASH needs required for practising and optimising self-care, and the potential barriers to an individual’s access to WASH services.


  • recommit to morbidity management and disability prevention as a central pillar and priority of LF and leprosy programmes
  • define new programme outcomes and objectives
  • develop a strong evidence base on the links between WASH and NTDs for self-care, and MMDP more widely
  • conduct further research to assess the minimum daily water needs for disabled people and those with additional needs due to chronic illness
  • ensure that interventions to tackle stigma form a core part of all MMDP interventions.
  • deliver fully-inclusive WASH services to poor communities where these diseases are endemic
  • integrate self-care programmes across causes of disability
  • build capacity, share best practise and implement training around issues of joint interest.
  • identify shared communication opportunities and messaging
  • ensure that those affected by LF and leprosy are involved in design and monitoring
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