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Basic Care Package Curbs Three Diseases

Sometimes, the simple things in health prevention are surprisingly effective. That certainly is true of an innovative intervention that is saving lives across Africa, one that contributes to CDC’s goal to promote health around the globe by sharing knowledge and tools to protect health.

The Basic Care Package is being distributed in Uganda and other African countries through a collaborative effort among CDC, the Uganda Ministry of Health, the AIDS Support Organization, and other partners, and through support from the President’s Emergency Plan for AIDS Relief (PEPFAR). Research conducted in rural Uganda and elsewhere in Africa demonstrated that the Basic Care Package is a low-cost, evidence-based way to reduce deaths, hospital visits, and illnesses, including malaria and diarrhea, among HIV-positive persons and their families.

The package includes two insecticide-treated mosquito nets; a water vessel, filter cloth, and bleach solution to disinfect water; information on HIV prevention and care (including cotrimoxazole, an antibiotic used to reduce opportunistic infections in persons who are positive for HIV); information on how to use the package components; and condoms when requested. Studies conducted by CDC and its partners show that the daily use of cotrimoxazole has reduced mortality by 46%; bed nets have reduced malaria incidence by 50%; and the simple home based safe water system has reduced diarrheal disease by 25%. In the last two and a half years, 120,000 Basic Care Packages have been distributed to HIV-positive families in Uganda alone.

Safe Water System to Save 500 Children per Day

“Unsafe water is a key health risk.” That simple statement drives a health intervention that is making a difference in the lives of people across the globe and is now receiving national recognition.

Through implementation of its Safe Water System Initiative, CDC is delivering a simple solution to some of the world’s most complex health problems. Over 1.1 billion people worldwide do not have access to safe drinking water. As a result, diarrhea and other preventable waterborne diseases claim the lives of an estimated 2 million children each year.

The initiative helps people store their water safely and treat it with a chlorine solution before use. It is economically self-sustaining through local entrepreneurship; and each year the initiative shows increased progress and promise. The system has been proven to reduce diarrheal disease in users by 22%–84%. Additionally, the chlorine treatment costs 25 cents for a 4-to-6 week supply, making it an affordable option in some of the world’s poorest communities.

In collaboration with CDC’s Partner, Population Services International (PSI), approximately 12 million bottles of chlorine solution were sold in 19 countries between 2006 and 2007. This amount is sufficient to treat more than 12 billion liters of water—enough drinking water for 16.5 million people in FY2007.

Point-of-use water treatment is relatively new to the scene but is gaining recognition as indicated by the recent creation of the International Network for the Promotion of Household Water Treatment and Safe Storage. This network includes dozens of organizations and a secretariat based at the World Health Organization.

Clean drinking water is especially critical for HIV-infected persons, whose weakened immune systems make them vulnerable to opportunistic infection, some of which are spread through unclean water. In western Kenya, nearly one in five adults is infected with HIV and nearly 20% of children are orphaned. A “Basic Care Package” developed by CDC includes the Safe Water System (water vessel, filter cloth, and bleach solution) as well as instructions for household water treatment methods. The Safe Water System alone has been documented to reduce diarrhea among HIV-infected persons by 25%–35%, at a cost of only $10 per family per year. When combined with the powerful antibiotic cotrimoxazole (Bactrim), the system has reduced diarrhea episodes by 77%.

This low-cost and effective intervention is being scaled up under the President’s Emergency Plan for AIDS Relief, and supports CDC’s goal to promote health around the globe by sharing knowledge and tools to protect health. Over the past year, the Safe Water System Initiative has grown to a total of 19 countries, and new programs were launched in Ethiopia, Burundi, Guinea, and Cameroon, with Haiti and Angola not long behind. CDC estimates that expansion of the program could save the lives of up to 500 children every day