Evans School Policy Analysis & Research Group (EPAR)

Limited sanitation infrastructure, poor hygienic practices, and unsafe drinking water negatively affect the health of millions of people in the developing world. Using sanitation interventions to interrupt disease pathways can significantly improve public health. Sanitation interventions primarily benefit public health by reducing the prevalence of enteric pathogenic illnesses, which cause diarrhea. Health benefits are realized and accrue to the direct recipients of sanitation interventions and also to their neighbors and others in their communities. In a report to the United Nations Development Programme (UNDP), Hutton et al. (2006) estimate that the cost-benefit ratio of sanitation interventions in all developing countries worldwide is 11.2. This literature review summarizes the risks of inadequate sanitation to public health and presents the empirical evidence on the public health benefits of complete, intermediate and multiple factor sanitation interventions. We find that complete or improved sanitary systems can offer concrete public health benefits by reducing exposure pathways to a variety of infectious diseases contained in human feces and wastewater. Substantial complementary economic gains are also predicted to accrue as a result of providing increased sanitation. In addition,  community-wide sanitation interventions seem to offer the greatest promise for reducing pathogenic health risks from feces.

Ecosystem services are the benefits people obtain from ecosystems, such as provisioning of fresh water, food, feed, fiber, biodiversity, energy, and nutrient cycling. Agricultural production can substantially affect the functioning of ecosystems, both positively and negatively. The purpose of this report is to provide an overview of the impacts of agricultural technologies and practices on ecosystem services such as soil fertility, water, biodiversity, air, and climate. The report describes the environmental impacts of different aspects of intensive cropping practices and of inputs associated with intensification. We further explore these impacts by examining intensive rice systems and industrial crop processing. Although this report focuses on the impacts of agricultural practices on the environment, many of the practices also have implications for plant, animal, and human health. Farmers and others who come in contact with air, water, and soils polluted by chemical fertilizers and pesticides may face negative health consequences, for instance. By impacting components of the ecosystem, these practices affect the health of plants and animals living within the ecosystem. We find that the unintended environmental consequences of intensive agricultural practices and inputs are varied and potentially severe. In some cases, sustaining or increasing agricultural productivity depends upon reducing impacts to the environment, such as maintaining productive soils by avoiding salinization from irrigation water. However, in other cases, eliminating negative environmental impacts may involve unacceptable trade-offs with food provision or other development goals. Determining the appropriate balance of costs and benefits from intensive agricultural practices is a location-specific exercise requiring knowledge of natural, economic, and social conditions.