Antibiotic resistance: using a cultural contexts of health approach to address a global health challenge

This policy brief has been developed in response to the contemporary challenge of antibiotic resistance (ABR). ABR poses a formidable threat to global health and sustainable development. It is now increasingly recognized that the systematic neglect of cultural factors is one of the biggest obstacles to achieving better health outcomes and better standards of living worldwide. Using a cultural contexts of health approach, the policy brief explores the centrality of culture to the challenge of ABR. The brief examines how the prescription and use of antibacterial medicines, the transmission of resistance, and the regulation and funding of research are influenced by cultural, social and commercial, as well as biological and technological factors. The brief moves beyond the ready equation of culture with individual behaviours and demonstrates how culture serve as an enabler of health and provide new possibilities for change.

Sanitation safety planning as a tool for achieving safely managed sanitation systems and safe use of wastewater

Increasing water stress and growing urbanization force a greater number of people to use wastewater asan alternative water supply, especially for irrigation. Although wastewater irrigation in agriculture has along history and substantial benefits, without adequate treatment and protective measures on farms andin markets, use of wastewater poses risks to human health and the environment. Against this background,the World Health Organization (WHO) published Guidelines for the safe use of wastewater, excreta andgreywater in agriculture and aquaculture, in 2006. The Sanitation safety planning: manual for safe use anddisposal of wastewater, greywater and excreta – a step-by-step risk-based management tool for sanitationsystems – was published by WHO in 2016 to put these guidelines into practice. Sanitation safety planning(SSP) can be applied to all sanitation systems, to ensure the systems are managed to meet health objectives.This paper summarizes the pilot-testing of the SSP manual in India, Peru, Portugal, Philippines, Ugandaand Viet Nam. Also reviewed are some of the key components of the manual and training, and an overviewof SSP training and dissemination efforts and opportunities for implementation in the WHO South-East AsiaRegion. Lessons learnt during the piloting phase show how reducing health risks can be surprisingly easy,even in a low-income setting, especially when combining many smaller measures. The SSP approach canmake an important contribution towards Sustainable Development Goal target 6.3, by reducing pollution,eliminating dumping and minimizing the release of hazardous chemicals and materials, thereby halving theproportion of untreated wastewater and substantially increasing recycling and safe reuse globally