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A planetary health innovation for disease, food and water challenges in Africa

Author

Listed:
  • Jason R. Rohr

    (University of Notre Dame)

  • Alexandra Sack

    (University of Notre Dame)

  • Sidy Bakhoum

    (Université Cheikh Anta Diop)

  • Christopher B. Barrett

    (Cornell University)

  • David Lopez-Carr

    (University of California)

  • Andrew J. Chamberlin

    (Stanford University
    Stanford University)

  • David J. Civitello

    (Emory University)

  • Cledor Diatta

    (Centre de Recherche Biomédicale Espoir pour la Santé)

  • Molly J. Doruska

    (Cornell University)

  • Giulio A. Leo

    (Stanford University)

  • Christopher J. E. Haggerty

    (University of Notre Dame)

  • Isabel J. Jones

    (Stanford University
    Stanford University)

  • Nicolas Jouanard

    (Centre de Recherche Biomédicale Espoir pour la Santé
    Station d’Innovation Aquacole)

  • Andrea J. Lund

    (Stanford University
    University of Colorado School of Public Health, Anschutz Medical Campus)

  • Amadou T. Ly

    (Centre de Recherche Biomédicale Espoir pour la Santé)

  • Raphael A. Ndione

    (Centre de Recherche Biomédicale Espoir pour la Santé)

  • Justin V. Remais

    (University of California)

  • Gilles Riveau

    (Centre de Recherche Biomédicale Espoir pour la Santé
    Université Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR 9017-CIIL-Center for Infection and Immunité of Lille)

  • Anne-Marie Schacht

    (Centre de Recherche Biomédicale Espoir pour la Santé)

  • Momy Seck

    (Station d’Innovation Aquacole)

  • Simon Senghor

    (Centre de Recherche Biomédicale Espoir pour la Santé)

  • Susanne H. Sokolow

    (Stanford University)

  • Caitlin Wolfe

    (University of South Florida)

Abstract

Many communities in low- and middle-income countries globally lack sustainable, cost-effective and mutually beneficial solutions for infectious disease, food, water and poverty challenges, despite their inherent interdependence1–7. 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 fuelling the growth of submerged aquatic vegetation that chokes out water access points and serves as habitat for freshwater snails that transmit Schistosoma parasites to more than 200 million people globally8–10. In a cluster randomized controlled trial (ClinicalTrials.gov: NCT03187366) in which we removed invasive submerged vegetation from water points at 8 of 16 villages (that is, 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 to 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 habitats. 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 planetary health solutions11 to the many and formidable, co-dependent global grand challenges of the twenty-first century.

Suggested Citation

  • Jason R. Rohr & Alexandra Sack & Sidy Bakhoum & Christopher B. Barrett & David Lopez-Carr & Andrew J. Chamberlin & David J. Civitello & Cledor Diatta & Molly J. Doruska & Giulio A. Leo & Christopher J, 2023. "A planetary health innovation for disease, food and water challenges in Africa," Nature, Nature, vol. 619(7971), pages 782-787, July.
  • Handle: RePEc:nat:nature:v:619:y:2023:i:7971:d:10.1038_s41586-023-06313-z
    DOI: 10.1038/s41586-023-06313-z
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    Citations

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    Cited by:

    1. Fabian Reitzug & Narcis B. Kabatereine & Anatol M. Byaruhanga & Fred Besigye & Betty Nabatte & Goylette F. Chami, 2024. "Current water contact and Schistosoma mansoni infection have distinct determinants: a data-driven population-based study in rural Uganda," Nature Communications, Nature, vol. 15(1), pages 1-15, December.
    2. Molly J Doruska & Christopher B Barrett & Jason R Rohr, 2024. "Modeling how and why aquatic vegetation removal can free rural households from poverty-disease traps," Papers 2401.17384, arXiv.org.

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