GSK: Preventing Disease with WASH Projects
Each year, 3 million people die from a disease that is so easily prevented. GlaxoSmithKline decided that prevention is the best medicine in the spread of diarreal disease and since 1998 has combatted the problem through the Personal Hygiene and Sanitation Education (PHASE) program.
Diarrhea is the biggest cause of child mortality in Sub-Saharan Africa and the second-biggest killer of children worldwide, accounting for 2.2 million children’s lives and killing more under-five-year-olds than AIDS, malaria, and measles combined. The spread of diarreal disease can be easily prevented by improving water quality and encouraging people to wash their hands. PHASE tackles both issues in partnership with other organizations, so far reaching more than 1.4 million children in some of the world’s poorest communities.
GSK's three primary areas of business are pharmaceuticals, vaccines and consumer healthcare.
GSK CEO Sir Andrew Witty, recently commented, "one of our key priorities is to continue to align our commercial success with forming new partnerships to tackle the healthcare needs of people in developing countries."
Since the pilot in Kenya in 1998, GSK has invested $9.4 million to extend PHASE to 16 countries across sub-Saharan Africa, Central and South America, South East Asia, and Europe. The program includes four of 15 countries (India, Bangladesh, Uganda, Kenya) that globally account for 75% of annual child deaths due to diarrhea.
The PHASE approach requires that education ministries, local government departments, and school teachers jointly plan and implement PHASE in the classroom. These local partnerships are supported by NGOs, mainly GSK’s strategic partners including AMREF, Save the Children, Plan International, Pratham, Millennium Development Villages, Firjan and Fit for School.
PHASE has three main features that help ensure success of the approach:
- The development of water, sanitation, and hand washing facilities in schools.
- In-school education about hygiene and sanitation practices using child-friendly and context specific materials and techniques.
- ‘Child-to-child’ or ‘child-to-family’ education on hygiene and sanitation practices essential to health and wellbeing.
Teachers and community leaders are trained to develop and deliver PHASE content as part of the school curriculum. They receive a toolkit of educational materials including posters, cloth books, and thematic story cards. Each country adapts the pictures to reflect local realities, and the children themselves are involved in selecting the materials’ message and illustration and their eventual use. Children become passionate PHASE facilitators, sharing what they have learned with their caregivers and communities.
PHASE has also been used in emergency situations such as the 2006 tsunami, 2007 Indonesian earthquake, the flood-prone areas in Bangladesh.
Sharing knowledge across several staff members has improved the continuity and sustainability of PHASE programs and there are now ‘PHASE experts’ working globally. In 2012, GSK aims to set up a model for integrating PHASE with school de-worming as part of its albendazole donation program. Albendazole is used to treat infections caused by worms and GSK has committed to donate 400 million albendazole treatments each year to the World Health Organization to enable de-worming of school-age children in all endemic countries until 2020.
What GlaxoSmithKline has Accomplished
More than 1.4 million children have benefitted from the program. Highlights include:
- Impacting education policy and school curriculum:A common approach is to pilot PHASE in a few schools before securing support for replication at scale via the school curriculum. In Kenya, following work in 247 schools, the government incorporated PHASE within the national curriculum for all government-run schools.
- Improving child health: In Nicaragua a five-fold increase in hand washing after latrine use was observed among pupils, and the proportion of children reporting diarrhea in a two-week period fell from over 40% to just 13%.
- Education outcomes: A positive correlation is also reported between the presence of PHASE in school attendance, participation and academic achievement. In Bangladesh school attendance rose from 66% to 75% and school completion from 55% to 68% following the implementation of PHASE.
- Relevance to wider public and child health issues: PHASE is often dovetailed into existing child and community-based development projects. One successful example is the ‘Attitude Positiva’ program which raises HIV/AIDS awareness among older school children in Rio de Janeiro, Brazil. PHASE is also being used to assist young people to devise strategies to address chronic living conditions exacerbated by inadequate sanitation facilities.
Why This Project Makes Sense
Due to lessons learned and successful impact from nearly 15 years of PHASE work, GSK has embraced the opportunity to find further synergies with its core business lines such as Vaccines, Oral Health, Community Healthworker Training, and Deworming programmes, where PHASE can be integrated, increasing leverage, influence and scale. The PHASE approach also advances GSK’s global relationships with a network of schools, governments, and communities. Data from the program’s activities show proof of positive impact in urban as well as rural environments, in the developed world as well as developing. PHASE is also applicable in post-disaster situations and can easily accompany existing programs, such as school-based health and nutrition activities.