Establishing real-time evaluations of WASH interventions on disease outbreaks in emergency settings

Principal Investigator: Oliver Cumming


Collaborators: Lauren D’Mello-Guyett (LSHTM), Peter Maes (MSF), Rafael Van den Bergh (MSF)


The role of water, sanitation and hygiene (WASH) interventions as a means to both preventing and controlling infectious disease outbreaks is well established. However, at a practice and policy level, there have been numerous recent calls to address a perceived evidence gap as to how WASH interventions can be best mobilized, and to what impact, during outbreak responses.


More rigorous research that identifies interventions and approaches that optimize the contribution of WASH, in health facilities and in the community in low and middle income countries, to outbreak control strategies, may improve the efficiency of investments and yield significant public health benefits. There are numerous guidance manuals on the management of WASH in outbreaks and other emergencies, produced by different international agencies involved in emergency humanitarian relief, but with often divergent or conflicting messages. This lack of convergence further illustrates the need for better evidence that might inform future guidelines and improve the cohesion and coordination of multi-agency responses.

This research study will aim to:

  • Evaluate the outbreak response of a chosen humanitarian agency, using an appropriate study design
  • Measure the impact and outcome of WASH interventions on secondary transmission of disease in a humanitarian crisis in low and middle income countries.
  • And, to strengthen the evidence base for chosen interventions and how they maximise and contribute to control and prevention of disease in crises-affected populations.


This research brings together the operational expertise of Médecins Sans Frontières (MSF), the London School of Hygiene and Tropical Medicine (LSHTM) and the UK Rapid Support Team (UKRST). The study is funded by the MSF and the UKRST.