Even then, Hunter warned of a lamentable lack of cooperation between the agriculture and health sectors and called for urgent remedial action.

Then, in 1992, a comprehensive monograph for many regions of Africa, Asia and Latin America published by the World Health Organization showed, country by country, how, because of these NTDs and malaria, agricultural irrigation programmes in the previous decades had led to a deterioration in the health of hundreds of thousands, or even millions, of people who settled near these programmes. The report referred particularly to the negative health impacts of small earth dams built in Africa in their thousands in the 1970s and 1980s to irrigate the fields or as animal watering places.

Staff of GTZ, the German agency for technical cooperation, reported specific experience of this in German development cooperation programmes in Mali in the 1980s. They found that in the area surrounding agricultural irrigation projects the prevalence of schistosomiasis was six times higher than in places without irrigation.

Because the prevalence of schistosomiasis around natural water sources was three times lower than at artificially created ones, they concluded that schistosomiasis in Mali during the 1980s was essentially a man-made health problem.