{"id":263986,"date":"2026-04-24T14:00:00","date_gmt":"2026-04-24T18:00:00","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&#038;p=263986"},"modified":"2026-04-25T16:00:55","modified_gmt":"2026-04-25T20:00:55","slug":"sph-in-india-partnering-for-progress-on-disease-climate-and-sanitation","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2026\/sph-in-india-partnering-for-progress-on-disease-climate-and-sanitation\/","title":{"rendered":"SPH in India: Partnering for Progress on Disease, Climate, and Sanitation"},"content":{"rendered":"\t<div class=\"wp-block-editorial-leadin sphnews-block-editorial-leadin is-style-text-over-image has-media has-media-focus-left-middle has-text-position-x-left has-text-position-y-bottom\">\n\t\t<div class=\"container-lockup\">\n\n\t\t\t<div class=\"wp-block-leadin-media\">\n\t\t\t\t\n\t\t\t\t<img width=\"1512\" height=\"754\" src=\"\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929.jpg\" class=\"\" alt=\"A SHRI Foundation communal toilet facility in India. Photo: Suryan and Dang\" loading=\"lazy\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929.jpg 1512w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-636x317.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-1024x511.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-768x383.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-755x377.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-900x449.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/SHRI_basgodanorth_20221115_1929-1200x598.jpg 1200w\" sizes=\"(max-width: 1512px) 100vw, 1512px\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\n\t\t\t\n\t\t\t\t<div class=\"container-words-outer\">\n\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"container-words-inner\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"wp-prepress-tag\">maternal and child health<\/span>\n\t\t\t\t\t\t\t\t<h1 class=\"head\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tSPH in India: Partnering for Progress on Disease, Climate, and Sanitation\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"deck\">Researchers at the School of Public Health collaborate with partners across India to combat tuberculosis, improve maternal and child health, map air pollution and heat risk, and expand access to water, sanitation, and hygiene.<\/h4>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div>\n\n\t\t\n\t<\/div>\n\n\t\n<div class=\"wp-prepress-component-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">April 24, 2026<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t\t\t\t<ul data-credit-type=\"By\">\n\t\t\t\t\t\t<li><a href=\"https:\/\/www.bu.edu\/sph\/news\/authors\/megan-jones\/\">Megan Jones<\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t\n\n\n<p>As India launches its first national <a href=\"https:\/\/economictimes.indiatimes.com\/news\/india\/india-begins-its-first-digital-census-in-16-years-and-this-time-theres-a-big-difference\/articleshow\/129995808.cms?from=mdr\" target=\"_blank\" rel=\"noreferrer noopener\">census<\/a> in 15 years following a COVID-related postponement from 2021, researchers at the School of Public Health and their Indian collaborators foresee opportunities to strengthen and scale their existing portfolios of work on air pollution, sanitation access, tuberculosis, and maternal and child health in the <a href=\"https:\/\/www.un.org\/development\/desa\/pd\/content\/india-overtakes-china-world%E2%80%99s-most-populous-country\" target=\"_blank\" rel=\"noreferrer noopener\">world\u2019s most populous country<\/a>.<\/p>\n\n\n\n<p>Over the course of the 2026 \u2013&nbsp;2027 year, India will attempt to gather information on the household characteristics and living conditions of an estimated 1.4 billion people\u2014data SPH researchers rely on for contextualizing their findings but may not currently reflect the true realities facing the population.<\/p>\n\n\n\n<p>\u201cIt&#8217;s a massive effort,\u201d says <a href=\"https:\/\/www.bu.edu\/sph\/profile\/akshay-gupte\/\">Akshay Gupte<\/a>, an assistant professor in the Department of Global Health, who grew up in Pune, India and trained as a physician before coming to the U.S. to build a research career focused on infectious and chronic lung diseases in low- and middle-income settings, including tuberculosis (TB) in India.<\/p>\n\n\n\n<h2>Tuberculosis Prevention &amp; Treatment<\/h2>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-large is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2022\/08\/Akshay-Gupte-1024x1024.jpg\" alt=\"Akshay Nitin Gupte, PhD, Assistant Professor, Global Health\" class=\"wp-image-237839\" width=\"297\" height=\"297\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-1024x1024.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-636x636.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-150x150.jpg 150w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-768x768.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-1536x1536.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-755x755.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-1000x1000.jpg 1000w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-500x500.jpg 500w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-1200x1200.jpg 1200w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-900x900.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-550x550.jpg 550w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-710x710.jpg 710w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-300x300.jpg 300w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-600x600.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte-100x100.jpg 100w, https:\/\/www.bu.edu\/sph\/files\/2022\/08\/Akshay-Gupte.jpg 1670w\" sizes=\"(max-width: 297px) 100vw, 297px\" \/><figcaption>Akshay Gupte, assistant professor of global health<\/figcaption><\/figure><\/div>\n\n\n\n<p>\u201cIn a country as diverse and spread out as India, getting a good census is an incredible feat of logistics,\u201d says Gupte. \u201c[But] those data are valuable because we often compare characteristics of TB patients with expectations from the general population. The census collects valuable data on socioeconomic status and standard-of-living indices, so we can geo-map cases and get a sense of the communities they&#8217;re coming from.\u201d<\/p>\n\n\n\n<p>While TB is \u201ccurable,\u201d eliminating the disease has proven challenging, says Gupte.<\/p>\n\n\n\n<p>\u201cTB is inherently linked with socioeconomic status and poverty. That doesn&#8217;t mean it can&#8217;t affect someone with higher [socioeconomic status], but it&#8217;s more prevalent in vulnerable populations who don&#8217;t have access to good care, are malnourished, and so on,\u201d he says. \u201cIn terms of progress, we&#8217;ve made good progress in diagnosis\u2014we have diagnostic tools that can pick up disease quickly. The challenge is finding everyone who needs to be diagnosed\u2014a vast number still go undiagnosed.\u201d<\/p>\n\n\n\n<p>The longer a patient\u2019s disease is left untreated, says Gupte, the greater the patient\u2019s risk of treatment failure, relapse, and worse long-term health outcomes, as well as the higher the likelihood that they spread the infection.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-large is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1024x1024.jpg\" alt=\"Robert Horsburgh\" class=\"wp-image-204685\" width=\"290\" height=\"290\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1024x1024.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-636x636.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-150x150.jpg 150w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-768x768.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1536x1536.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-2048x2048.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-755x755.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1000x1000.jpg 1000w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-500x500.jpg 500w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1200x1200.jpg 1200w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-900x900.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-1920x1920.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-550x550.jpg 550w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-710x710.jpg 710w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-300x300.jpg 300w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-600x600.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2013\/10\/Robert-Horsburgh-1-100x100.jpg 100w\" sizes=\"(max-width: 290px) 100vw, 290px\" \/><figcaption>Robert Horsburgh, professor of global health<\/figcaption><\/figure><\/div>\n\n\n\n<p>Gupte\u2019s work on lung injury after TB infection is one of a variety TB-related research efforts under the umbrella of Regional Prospective Observational Research for Tuberculosis <a rel=\"noreferrer noopener\" href=\"https:\/\/reportindia.org\/\" target=\"_blank\">(RePORT) India<\/a>, a multi-organizational, collaborative consortium funded bilaterally by the National Institutes of Health (NIH) and the Government of India and the largest of six regional TB consortia worldwide (China, Brazil, Indonesia, Philippines, and South Africa). Fellow physician-scientist and professor of global health <a href=\"https:\/\/www.bu.edu\/sph\/profile\/charles-horsburgh\/\">Robert Horsburgh<\/a> is BU\u2019s principal investigator for RePORT India and sits on the executive committee.<\/p>\n\n\n\n<p>Horsburgh has studied TB for decades, producing evidence that can inform clinical guidelines (<a rel=\"noreferrer noopener\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40925610\/\" target=\"_blank\">dosing<\/a> of rifampin to treat TB during pregnancy, for example), support targeted public health interventions (such as <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40833109\/\">nutrition<\/a> and <a rel=\"noreferrer noopener\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40939932\/\" target=\"_blank\">alcohol misuse<\/a> programs), and strengthen the evidence base for <a rel=\"noreferrer noopener\" href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC12453202\/\" target=\"_blank\">stigma\u2011reduction<\/a> and <a rel=\"noreferrer noopener\" href=\"https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciag079\/8471779\" target=\"_blank\">screening<\/a> strategies.<\/p>\n\n\n\n<h2>Maternal and Child Health<\/h2>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2016\/07\/Patricia-Hibberd-1.jpg\" alt=\"Patricia Hibberd\" class=\"wp-image-134248\" width=\"295\" height=\"295\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1-150x150.jpg 150w, https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1-500x500.jpg 500w, https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1-550x550.jpg 550w, https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1-300x300.jpg 300w, https:\/\/www.bu.edu\/sph\/files\/2016\/07\/Patricia-Hibberd-1-100x100.jpg 100w\" sizes=\"(max-width: 295px) 100vw, 295px\" \/><figcaption>Patricia Hibberd, chair and professor of global health<\/figcaption><\/figure><\/div>\n\n\n\n<p>Like her colleagues, <a href=\"https:\/\/www.bu.edu\/sph\/profile\/patricia-hibberd\/\">Patricia Hibberd<\/a>, chair and professor of global health, also has extensive clinical training and expertise in infectious disease to complement a long legacy of research activities in India. Hibberd recalls first beginning work in the country in 1996 when the World Health Organization (WHO) invited her to help design a clinical trial investigating ways to better treat childhood pneumonia. At a meeting with the other investigators on the project, she met her Indian counterpart, <a rel=\"noreferrer noopener\" href=\"https:\/\/scholar.google.com\/citations?user=gCbIESgAAAAJ&amp;hl=en\" target=\"_blank\">Archana Patel<\/a>, program director of the <a rel=\"noreferrer noopener\" href=\"https:\/\/www.lmrf.org.in\/\" target=\"_blank\">Lata Medical Research Foundation<\/a> in Nagpur, India.<\/p>\n\n\n\n<p>Over the next thirty years, the two women would go on to become close collaborators, as they spearheaded maternal and child health (MCH) research collaborations through the <a href=\"https:\/\/www.rti.org\/impact\/global-network-womens-and-childrens-health\" target=\"_blank\" rel=\"noreferrer noopener\">Global Network<\/a>, a sprawling NIH\u2011coordinated research consortium with partner sites worldwide. Hibberd and Patel have collaborated to pilot and test a variety of sustainable, low-cost MCH interventions that have gone on to inform WHO guidance and global practice; examples of their contributions include the early recognition of severe hypoxemia and the use of oxygen to treat children with pneumonia in resource-constrained settings and the development of novel, point-of-care diagnostics for neonatal sepsis.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1024\" height=\"768\" src=\"\/sph\/files\/2026\/04\/DSC02318-1024x768.jpg\" alt=\"Patricia Hibberd (second from left) and Archana Patel (third from right) during a Global Network site visit to the Lata Medical Research Foundation (LMRF). Photo courtesy of LMRF. \" class=\"wp-image-263998\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318-1024x768.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318-636x477.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318-768x576.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318-755x566.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318-900x675.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/DSC02318.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>Patricia Hibberd (second from left) and Archana Patel (third from right) during a Global Network site visit to the Lata Medical Research Foundation (LMRF). Photo courtesy of LMRF. <\/figcaption><\/figure>\n\n\n\n<p>\u201cTo summarize our three decades of work and friendship in a comment or two is difficult but easy in one word: \u2018extraordinary!\u2019\u201d says Patel. \u201cDr. Hibberd and I began our research collaboration in India prior to the turn of the century [\u2026] with both of us serving as pediatric epidemiologists, a role relatively uncommon at the time. Since then, our research has continued successfully through numerous grants, studies, and publications encompassing intervention trials and observational studies aimed at improving maternal, neonatal, and child health in India and other resource-limited settings worldwide.\u201d<\/p>\n\n\n\n<h2>Air Pollution and Heat Risks<\/h2>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin.jpg\" alt=\"Kevin Lane\" class=\"wp-image-131900\" width=\"287\" height=\"287\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin-150x150.jpg 150w, https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin-500x500.jpg 500w, https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin-550x550.jpg 550w, https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin-300x300.jpg 300w, https:\/\/www.bu.edu\/sph\/files\/2018\/09\/HEADSHOT-FACULTY-2018-OFFICIAL-CROPPED-Lane_Kevin-100x100.jpg 100w\" sizes=\"(max-width: 287px) 100vw, 287px\" \/><figcaption>Kevin Lane, <meta charset=\"utf-8\">associate professor of environmental health<\/figcaption><\/figure><\/div>\n\n\n\n<p>To better understand the geographic distribution of air quality and other environmental health risks in India, <a href=\"https:\/\/www.bu.edu\/sph\/profile\/kevin-lane\/\">Kevin Lane<\/a>, associate professor of environmental health, collaborated with partners in India to build fine\u2011scale exposure maps that can be paired with on\u2011the\u2011ground health data and program footprints. As a member of the <a href=\"https:\/\/www.ashoka.edu.in\/consortium-for-climate-health-and-air-pollution-research-in-india-chair-india\/\" target=\"_blank\" rel=\"noreferrer noopener\">Consortium for Climate, Health and Air pollution Research in India (CHAIR-India)<\/a>, Lane helped to assemble satellite, ground monitoring, meteorologic, and land\u2011use data to produce daily PM2.5 and temperature estimates at 1\u2011kilometer resolution for the entire country for the 12-year period between 2008 and 2020.<\/p>\n\n\n\n<p>Analyses using the CHAIR models, conducted collaboratively with Indian investigators and public health agencies, have shown that both long\u2011term and short\u2011term particulate pollution are linked to increases in mortality, and that extreme heat and poor air quality interact to amplify risk. For example, a 2024 <a rel=\"noreferrer noopener\" href=\"https:\/\/www.thelancet.com\/journals\/lanplh\/article\/PIIS2542-5196(24)00248-1\/fulltext\" target=\"_blank\">study<\/a> coauthored by Lane and <a rel=\"noreferrer noopener\" href=\"https:\/\/www.bu.edu\/sph\/profile\/gregory-wellenius\/\" target=\"_blank\">Gregory Wellenius<\/a>, professor of environmental health and director of SPH\u2019s Center for Climate &amp; Health, and published in <em>Lancet Planetary Health<\/em> found that long-term exposure to air pollution consisting of particles smaller than 2.5 micrometers in diameter (PM2.5) increased mortality by 1.5 million deaths per year in India over the period of ten years between 2009 and 2019.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1024x416.jpg\" alt=\"\" class=\"wp-image-264017\" width=\"720\" height=\"292\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1024x416.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-636x258.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-768x312.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1536x624.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-2048x832.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-755x307.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1628x661.jpg 1628w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-900x365.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1920x780.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/mortality-rate-india-air-pollution-1200x487.jpg 1200w\" sizes=\"(max-width: 720px) 100vw, 720px\" \/><figcaption><meta charset=\"utf-8\">A figure showing mortality across India from Jaganathan S, Stafoggia M, Rajiva A et al. Estimating the effect of annual PM2\u00b75 exposure on mortality in India: a difference-in-differences approach. <em>The Lancet Planetary Health<\/em>, 8, e987-e996)<\/figcaption><\/figure><\/div>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1024\" height=\"439\" src=\"\/sph\/files\/2026\/04\/gr3_lrg-1024x439.jpg\" alt=\"\" class=\"wp-image-264018\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-1024x439.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-636x273.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-768x329.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-1536x658.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-2048x878.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-755x324.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-1628x698.jpg 1628w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-900x386.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-1920x823.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/gr3_lrg-1200x514.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption><meta charset=\"utf-8\">A figure showing <meta charset=\"utf-8\">PM2\u00b75 concentrations across India from Jaganathan S, Stafoggia M, Rajiva A et al. Estimating the effect of annual PM2\u00b75 exposure on mortality in India: a difference-in-differences approach. <em>The Lancet Planetary Health<\/em>, 8, e987-e996.<\/figcaption><\/figure>\n\n\n\n<p>Researchers on the project also mapped consistent and emerging pollution hotspots, including many districts and cities not previously flagged under national non\u2011attainment lists as exceeding legal pollution limits. CHAIR\u2019s work has concluded and the outputs of the consortium\u2019s investigations are now publicly available on the <a rel=\"noreferrer noopener\" href=\"https:\/\/www.climatehealthcafe.org\/\" target=\"_blank\">BUSPH-HSPH CAF\u00c9 Research Coordinating Center<\/a>\u2019s <a rel=\"noreferrer noopener\" href=\"https:\/\/www.climatehealthcafe.org\/cafe-dataverse-and-coding-resources\" target=\"_blank\">dataverse<\/a> so Indian researchers, state health departments, and national programs can download the exposure layers to guide policy and program development.<\/p>\n\n\n\n<p>Lane emphasizes that the project\u2019s value lies not only in the models and publications, but in the shared tools and local collaborations that allowed the exposure data to be shared publicly for India\u2019s public health professionals and others to reference.<\/p>\n\n\n\n<h2>Water, Sanitation, and Hygiene<\/h2>\n\n\n\n<p>Since 2010, <a href=\"https:\/\/www.bu.edu\/sph\/profile\/anoop-jain\/\">Anoop Jain<\/a>, assistant professor of environmental health, has operated a nonprofit called <a href=\"https:\/\/www.sanrights.org\/\">Sanitation and Health Rights in India<\/a> (SHRI) that both provides community toilet facilities to some of India\u2019s densest, most impoverished areas and serves as a platform for SPH research. The model yields immediate health benefits for users\u2014including private stalls, functioning toilets, clean water, and a rigorous cleaning and maintenance protocol\u2014as well as a steady flow of evidence and proof of concept in support of shared toilets to India\u2019s government.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"alignright size-full is-resized\"><img loading=\"lazy\" src=\"\/sph\/files\/2023\/08\/Anoop-Jain.png\" alt=\"Headshot of Anoop Jain\" class=\"wp-image-234097\" width=\"304\" height=\"304\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2023\/08\/Anoop-Jain.png 421w, https:\/\/www.bu.edu\/sph\/files\/2023\/08\/Anoop-Jain-150x150.png 150w, https:\/\/www.bu.edu\/sph\/files\/2023\/08\/Anoop-Jain-300x300.png 300w, https:\/\/www.bu.edu\/sph\/files\/2023\/08\/Anoop-Jain-100x100.png 100w\" sizes=\"(max-width: 304px) 100vw, 304px\" \/><figcaption>Anoop Jain, assistant professor of environmental health<\/figcaption><\/figure><\/div>\n\n\n\n<p>Because WHO\u2019s joint monitoring program does not consider shared sanitation facilities like SHRI\u2019s to be \u201cimproved\u201d due to concerns that poorly maintained facilities might exacerbate the spread of disease, Jain is leveraging pilot funding from SPH to test a new method of evaluating the cleanliness of shared surfaces using adenosine triphosphate swabs\u2014the more organic matter present, the more ATP that is detected. He is also collaborating with another organization based in India and the Centers for Disease Control and Prevention to better understand the types of bacterial and viral material on these surfaces and whether it is pathogenic.<\/p>\n\n\n\n<p>Jain has also been busy rapidly scaling the SHRI Foundation\u2019s facilities, growing from 18 community sanitation facilities in April 2024 to 32 facilities across several states in April 2026. Thanks to a recent influx of new funding from the nonprofit foundation <a href=\"https:\/\/www.rippleworks.org\/\">Rippleworks<\/a>, Jain also plans to extend the SHRI model into schools and government health centers, and he hopes to secure an additional grant to launch a menstrual\u2011friendly schools initiative.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" width=\"1024\" height=\"683\" src=\"\/sph\/files\/2026\/04\/IMG_8128-1024x683.jpg\" alt=\"Two children look on as a a young girl washes her hands and two others chat with one another inside a SHRI Foundation women's toilet facility. Photo: Suryan and Dang\" class=\"wp-image-264001\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-1024x683.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-636x424.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-768x512.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-1536x1025.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-2048x1366.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-755x504.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-1499x1000.jpg 1499w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-900x600.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-450x300.jpg 450w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-600x400.jpg 600w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-1920x1281.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2026\/04\/IMG_8128-1200x800.jpg 1200w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><figcaption>Two children look on as a a young girl washes her hands and two others chat with one another inside a SHRI Foundation women&#8217;s toilet facility. Photo: Suryan and Dang<\/figcaption><\/figure>\n\n\n\n<p>For Jain, a quality experience is paramount.<\/p>\n\n\n\n<p>\u201cI&#8217;m really interested in how sanitation shapes mental health outcomes,&#8221; he says. &#8220;Over the last 15 \u2013 16 years, I&#8217;ve heard people describe the stress, anxiety, and shame of having to defecate in the open and how inadequate access shapes those outcomes.\u201d<\/p>\n\n\n\n<p>Installing functioning doors, for example, is a simple fix, he says. \u201cYou don&#8217;t need new technology, but you need a system to make sure the door gets put up, stays there, and is maintained so people feel comfortable using the facility. Otherwise, the work is wasted.\u201d<\/p>\n\n\n\n<p>With the support of a K01 award from the National Institute on Aging, Jain is currently investigating how sanitation shapes mental health outcomes among older and aging populations. He sees his research as sitting on either side of his mission to provide sanitation. On the one side, he is studying how to make sanitation high quality and on the other, he is studying how that high-quality sanitation might shape physical and mental health.<\/p>\n\n\n\n<p>Jain also views his work in India as a living expression of SPH&#8217;s mission: <em>Think. Teach. Do. For the Health of All.<\/em><\/p>\n\n\n\n<p>&#8220;The organization allows me to apply social epidemiology theory\u2014think, use material in my teaching\u2014teach, and bring real-world implementation to life\u2014do,\u201d he says.<\/p>\n\n\n\n<p>But none of it is possible without the right partners on the ground.<\/p>\n\n\n\n<p>&#8220;Since day one, I&#8217;ve relied heavily on partnerships in India,\u201d he says. \u201cYou can&#8217;t work in India in this field without local partners \u2014 [for] practical reasons like IRB, designing surveys in local languages, and so on. Substantively, it&#8217;s critical to have the right partners.\u201d<\/p>\n\n\n\t<aside class=\"wp-block-editorial-relatedstories is-style-card has-three sphnews-block-editorial-relatedstories\">\n\t\t<h3 class=\"wp-block-editorial-relatedstories-title\">Related<\/h3>\n\t\t<ul class=\"wp-block-editorial-relatedstories-list\">\n\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-block-editorial-relatedstories-article-image\">\n\t\t\t\t\t\t\t\t\t<img width=\"600\" height=\"362\" src=\"\/sph\/files\/2024\/10\/SHRI-IMG_8222-THUMB.jpg\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-editorial-relatedstories-article-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>India<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2024\/anoop-jain-researches-shared-toilet-facilities-serving-impoverished-communities-in-india\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">Anoop Jain Researches Shared Toilet Facilities Serving Impoverished Communities in India<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">October 4, 2024<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-block-editorial-relatedstories-article-image\">\n\t\t\t\t\t\t\t\t\t<img width=\"600\" height=\"362\" src=\"\/sph\/files\/2022\/10\/antibiotics-600.jpg\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Close-up female hands holding pills and medicine jar\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-editorial-relatedstories-article-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>antibiotic-resistant bacteria<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2022\/antibiotic-misuse-in-india-could-exacerbate-drug-resistance\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">Antibiotic Misuse in India Could Exacerbate Drug Resistance<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">October 28, 2022<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"wp-block-editorial-relatedstories-list-item\">\n\t\t\t\t\t<article class=\"wp-block-editorial-relatedstories-article\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-block-editorial-relatedstories-article-image\">\n\t\t\t\t\t\t\t\t\t<img width=\"600\" height=\"362\" src=\"\/sph\/files\/2024\/01\/SPHTY23-Theme-Department-Chairs-Hibberd.png\" class=\"attachment-post-thumbnail size-post-thumbnail wp-post-image\" alt=\"Black and white headshot of Patricia Hibberd with a yellow and white background\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"wp-block-editorial-relatedstories-article-content\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-category\"><span>Global Health<\/span><\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"wp-block-editorial-relatedstories-article-title\"><a href=\"https:\/\/www.bu.edu\/sph\/news\/articles\/2024\/whats-next-for-global-health\/\" class=\"wp-block-editorial-relatedstories-article-title-link\">What&#8217;s Next for Global Health?<\/a><\/h4>\n\t\t\t\t\t\t\t<p class=\"wp-block-editorial-relatedstories-article-date\">January 12, 2024<\/p>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t<\/article>\n\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t<\/aside>\n\t","protected":false},"excerpt":{"rendered":"<p>As India launches its first national census in 15 years following a COVID-related postponement from 2021, researchers at the School of Public Health and their Indian collaborators foresee opportunities to strengthen and scale their existing portfolios of work on air pollution, sanitation access, tuberculosis, and maternal and child health in the world\u2019s most populous country. [&hellip;]<\/p>\n","protected":false},"author":22210,"featured_media":263882,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[3889,2261,2265,4891,2525,506,2367,5055,3214,1771],"bu-publication":[3516],"sphnews-article-category":[3519,3529,3531,3532,3540],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[5472,4405,3626,2190,2134,5473],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/263986"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/22210"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=263986"}],"version-history":[{"count":32,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/263986\/revisions"}],"predecessor-version":[{"id":264136,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/263986\/revisions\/264136"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/263882"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=263986"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=263986"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=263986"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=263986"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=263986"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=263986"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=263986"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=263986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}