The 19th century was one of exploration, expansion, scientific discovery and mechanical inventions. It was also the century that made the connection between cleanliness and health.

It is interesting to note that the very word “sanitation”, which comes from the latin word for health, is actually defined as “the promotion of hygiene and prevention of disease by maintenance of sanitary conditions such as by removal of sewage and trash”.

Today sanitation is associated with cleanliness, which is something enforced by the state both in the domestic and commercial sectors.

By the mid 1800’s it was well recognised that the key to health lay with sanitation.

Sanitation was the life mission of Sir Edwin Chadwick, a lawyer who was brought in to assist in far reaching social reforms, notably in sanitation. He occupied the position of first Director of the Board of Health in England from 1848 to 1854. The position of Chadwick and his Board was that safeguarding public health was actually the province of the engineer, rather than the physician.

A massive cholera epidemic had hit London in 1831, leading to a push to greater sanitation. It was part of a cholera pandemic that lasted between 1816 and 1837.

In his publication The Sanitary Conditions of the Labouring Population, 1842, Chadwick successfully used quantitative methods to demonstrate the direct link between poor living conditions, disease and life expectancy. This lead to the passing of the new Public Health Act of 1848 and the establishment of the General Board of Health, of which Chadwick, a lawyer not a doctor, was appointed its first director.

Ref https://ia902809.us.archive.org/29/items/sanitaryconditi00grisgoog/sanitaryconditi00grisgoog.pdf

Chadwick is considered to be the founding father of public health in the Anglo Saxon world.

Through the efforts of Chadwick major strides were made in England in the field of sanitation, similar to those made in France, Germany and the United States, four of the major industrial powers of the 19th century, in an effort to fight disease.

Ref. https://www.britannica.com/biography/Edwin-Chadwick

https://en.wikipedia.org/wiki/Edwin_Chadwick

As a result disease in such countries started to decrease substantially, and it was universally recognised that the success was largely due to the rise in sanitation.

However during the mid 1800’s, with the increasing circulation of mass media and no form of content review in medical journals “almost anyone with or without proper education could publish a potential cure for disease. Actual medical professionals had to compete with the ever expanding pharmacy companies that were all too ready to provide new elixirs and promising treatments for the epidemics of the time”  

Ref https://en.wikipedia.org/wiki/Diseases_and_epidemics_of_the_19th_century

The competition between medical professionals and big pharma with all its claims of providing panaceas thus had its roots way back in the 19th century.

Meanwhile in other parts of the world sanitation still remained very lacking right through to the next two centuries.

As detailed on the World Health Organisation website:

“Some 827 000 people in low- and middle-income countries die as a result of inadequate water, sanitation, and hygiene each year, representing 60% of total diarrhoeal deaths. Poor sanitation is believed to be the main cause in some 432 000 of these deaths.

Diarrhoea remains a major killer but is largely preventable. Better water, sanitation, and hygiene could prevent the deaths of 297 000 children aged under 5 years each year.”

“A WHO study in 2012 calculated that for every US$ 1.00 invested in sanitation, there was a return of US$ 5.50 in lower health costs, more productivity, and fewer premature deaths.”

So according to the WHO’s own calculations, if $20 billion spent on vaccines in developing countries is spent on sanitation instead, it would lead to a saving of "$100 billion in health costs. That would mean major gains for those countries, but major loss of profits for the pharmaceutical companies.

In 2010, the UN General Assembly recognized access to safe and clean drinking water and sanitation as a human right and called for international efforts to help countries to provide safe, clean, accessible, and affordable drinking water and sanitation.

Ref https://www.who.int/news-room/fact-sheets/detail/sanitation

Right up to the present day this fundamental principle of the importance of sanitation for public health that had started to revolutionise public health in the industrialised world in the 19th century, is universally recognised. It has never been in dispute, and the statistics clearly show the correlation between sanitation and the reduction of disease and its transmission.

Yet we find that the commercial sector in health, in the form of the pharmaceutical industry, is very quick to try and take credit for the decline in infectious diseases in the 19th and 20th centuries in Europe and the USA, by quoting the statistics and claiming that they are proof positive that it is their products that have been mostly responsible for such decline, while they persistently fail to make mention of the revolution in sanitation.

Don’t miss episode 3, where we shall check out such claims and delve deeply into those statistics in order to establish an accurate pattern and cause of successes and setbacks in the fight against disease in the 19th and 20th centuries.