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WickedSchisto: Developing an robust interdisciplinary-informed WASH framework for the wicked public-health problem of schistosomiasis

In plain English

AI plain-English summary

Schistosomiasis—a parasitic disease spread through contaminated water—still infects over 240 million people, despite decades of mass drug distribution. The problem persists because pills alone cannot stop reinfection where people lack clean water, toilets, and basic hygiene (WASH). This project asks why current WASH interventions fall short and what combinations of sanitation, water access, and drug treatment actually work to eliminate the disease by 2030, as the World Health Organization aims to do. The researcher will measure the full health, economic, and social costs of schistosomiasis—not just infection rates—then model which WASH-and-drug packages deliver the best value for money. She will also track how human movement spreads the parasite across regions, and identify the policy levers that could sustain long-term control. If successful, the work will give governments in Uganda and other endemic countries a practical framework for choosing cost-effective interventions, rather than relying on repeated mass treatment alone. The same approach could apply to other waterborne diseases that resist simple fixes.

View original technical description
Over 240 million people have schistosomiasis, a debilitating disease intrinsically linked to inadequate water, sanitation and hygiene (WASH). A wicked problem is a social or cultural problem that is difficult or impossible to solve. Despite extensive mass drug administration (MDA), schistosomiasis remains a wicked public-health problem. WASH-interventions are needed to reach the World Health Organization (WHO) 2030 goal of elimination as a public-health problem. Yet we don't understand the full impact of schistosomiasis, and therefore cannot identify what feasible and cost-effective WASH interventions best reduce this impact, nor the threats to long-term control programme success, and how to mitigate these. I will address five ambitious questions: 1. What are the true health, economic and societal impacts of schistosomiasis? 2. What are the most cost-effective combinations of WASH and MDA interventions? 3. How best can we scale-up these public-health WASH interventions to reach WHO 2030 goals? 4. What are the risks from human mobility to achieving and sustaining WHO 2030 goals? 5. How can cross-sectorial policy buy-in be leveraged to help reach these goals? I will use innovative interdisciplinary methods to tackle this wicked public-health problem including: an unprecedented, bottom-up approach to identify acceptable, equitable, cost-effective, feasible, multifaceted interventions with highest 'value for money' and impact on schistosomiasis health-related quality of life; develop a field-based morbidity marker to monitor success; combine state-of-the-art parasite genomics with mathematical models to inform on control programme endpoints; and identify community, through to international level, facilitators to leverage for intervention success. My pioneering research will inform policymakers in Uganda and beyond on how best to eliminate schistosomiasis. I will fill a critical global-health knowledge gap and provide a framework for other WASH-associated diseases.

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Researchers

Poppy Lamberton (Principal Investigator)

Related Research

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Elucidating the causes and consequences of persistent schistosomiasis hotspots
Cultural, social and economic influences on ongoing Schistosoma mansoni transmission, despite a decade of mass treatment, and the potential for change

Original classification

Research Grant

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