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Contributed Talk

Session: : Disease And Epidemiology 6

COS 282-4 - A planetary health solution for disease, sustainability, food, water, and poverty challenges in West Africa

Thursday, August 10, 2023
2:15 PM – 2:30 PM PDT
Location: D138
Abstract: Many communities in low- and middle-income countries globally lack sustainable, cost-effective, mutually beneficial solutions for infectious disease, food, water, and poverty challenges, despite their inherent interdependence. Here, we provide support for the hypothesis that agricultural development and fertilizer use in West Africa increase the burden of the parasitic disease schistosomiasis by fueling the growth of submerged aquatic vegetation that chokes out water access points and serves as habitat for freshwater snails that transmit Schistosoma parasites to >200 million people globally. In a cluster randomized controlled trial where we removed invasive submerged vegetation from water points at 8 of 16 villages (i.e., clusters), control sites had 1.46 times higher intestinal Schistosoma infection rates in schoolchildren and lower open water access than removal sites. Vegetation removal did not have any detectable long-term adverse effects on local water quality or freshwater biodiversity. In feeding trials, the removed vegetation was as effective as traditional livestock feed but 41-179 times cheaper and converting the vegetation to compost provided private crop production and total (public health plus crop production benefits) benefit-to-cost ratios as high as 4.0 and 8.8, respectively. Thus, the approach yielded an economic incentive—with important public health co-benefits—to maintain cleared waterways and return nutrients captured in aquatic plants back to agriculture with promise of breaking poverty-disease traps. To facilitate targeting and scaling of the intervention, we lay the foundation for using remote sensing technology to detect snail habitat. By offering a rare, profitable, win-win approach to addressing food and water access, poverty alleviation, infectious disease control, and environmental sustainability, we hope to inspire the interdisciplinary search for other planetary health solutions to the numerous and formidable, co-dependent global grand challenges of the 21st century.