Environmental factors often play a role in death and disease, especially the leading infectious diseases that affect children – acute respiratory infections, diarrhea and malaria.

• Acute lower respiratory infections, mainly pneumonia, are the leading cause of death among children under age 5 and are closely associated with exposure to indoor smoke from cooking with biomass fuels.
• Diarrhea, another leading killer of children is largely caused by unsafe water, inadequate sanitation and poor hygiene.
• Malaria has environmental dimensions as well.  USAID employs strict environmental guidelines, approval processes and procedures for the use of DDT, a pesticide used on crops to kill mosquitoes and all other World Health Organization-approved insecticides, ensuring their safe and judicious use.

USAID aims to provide global leadership in developing, implementing and promoting up-to-date interventions to prevent illness and death associated with environmental factors. 

Most efforts are focused on inadequate water supply, sanitation, and hygiene (WASH) to help reduce child mortality or reduce the burden on people living with HIV/AIDS. The focus is on populations in both rural and urban areas with the greatest risks of mortality from disease and, typically, the poorest access to quality WASH services.

USAID promotes proven technologies, such as household level chlorination which kills bacteria in water, community-led total sanitation, sanitation marketing and handwashing promotion.

USAID’s health activities work closely with other sectors to achieve measured changes in access to improved water supply and sanitation. 

• In fiscal year 2010, USAID provided more than 2.8 million people with improved access to drinking water supply and nearly 2.9 million with improved access to sanitation facilities.

The Agency also supports operational research to better understand adoption and use issues related to improved cookstoves to reduce indoor air pollution. Should these efforts show a demonstrated impact on outcomes of interest, especially childhood pneumonia, they will eventually be incorporated into USAID health activities.