6 September 2006
The world is in danger of missing targets for providing clean water and sanitation unless there is a dramatic increase in the pace of work and investment between now and 2015, the World Health Organization (WHO) and UNICEF said.
In their report "Meeting the MDG Drinking Water and Sanitation Target: The Urban and Rural Challenge of the Decade", both UN agencies said that the situation is becoming particularly acute in urban areas, where rapid population growth is putting great pressure on the provision of services and the health of poor people.
In 2000, the world pledged to reduce by half the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015. More than 1.1 billion people in both urban and rural areas currently lack access to drinking water from an improved source and 2.6 billion people do not have access to even basic sanitation, the report says.
The health impact of this can be seen particularly in children. In 2005, according to WHO estimates, 1.6 million children under age 5 (an average of 4,500 every day) died from the consequences of unsafe water and inadequate hygiene. Children are particularly at risk from water-related diseases such as diarrhoeal and parasitic diseases. Lack of sanitation also increases the risk of outbreaks of cholera, typhoid and dysentery.
The populations of urban areas in the developing world are growing rapidly and, if the Millennium Development Goals are to be met, a huge amount of work will have to be done simply to maintain the proportion of those living in cities with access to improved drinking water and adequate sanitation, the WHO said.
Currently, 95% of city dwellers have access to an improved source of drinking water, while 80% have access to sanitation services. "It is a tragedy that the world may not reach the water and sanitation MDGs. Safe drinking water and basic sanitation are so obviously essential to health that they risk being taken for granted," Acting WHO Director-General Dr Anders Nordstrom said.
"Efforts to prevent death from diarrhoea and other diseases are doomed to failure unless people have access to safe drinking water and basic sanitation. This report underlines the importance of the new WHO strategy on public health and environment to radically reduce the global burden of disease through preventive health measures. Only by tackling the root causes of diseases such as water and sanitation can we reduce the 24% global burden of global disease caused by the environment."
Meeting the water and sanitation MDG targets will be one of the most effective means of raising the health and general living standards of many of the world's poor. But reaching the water and sanitation targets will require much greater efforts by policymakers, funding and training agencies, planning and construction. These solutions must focus on poor and under-served people worldwide, the WHO said.
According to the report, meeting the sanitation MDG will require a doubling of current efforts. A one-third increase in efforts will be needed to meet the MDG drinking water target. While 1.2 billion people gained access to both improved drinking water sources and improved sanitation from 1990 to 2004, another 1.6 billion need to gain access from 2005 to 2015 to reach the MDG sanitation target, and 1.1 billion need to gain access to meet the drinking water target.
The report notes that the numbers express a blunt reality: business-as-usual is taking the sector towards a potential non-achievement of the global MDG sanitation target. The world, though making progress, is not on track to achieve the sanitation target. To reach that target means providing services to an additional 450,000 people a day from 2005 to 2015. This calls for almost doubling the current efforts.
Globally, urban coverage with improved sanitation crept up from 79% to 80% over 1990-2004. In contrast, rural sanitation coverage - despite increasing 13 percentage points over the same period - remains incredibly low at 39%. With 2 billion unserved in 2004 (two in every three rural citizens are unserved) and a projected 1.7 billion unserved in 2015, rural sanitation requires a massive concentration of effort to reduce substantially the urban/rural disparity in coverage.
The report says that although the world as a whole is on track to achieve the MDG drinking water target, the trend appears to be deteriorating, and in this respect points to two serious challenges: the inequity in coverage between rural and urban areas; and accelerating urban population growth in developing regions.
Reaching the MDG drinking water target will require the provision of services to an additional 300,000 people a day over the next decade; this means stepping up current efforts by almost one third.
Rural areas still lag far behind urban areas in terms of drinking water coverage from improved sources. Even though rural coverage increased from 64% in 1990 to 73% in 2004, some 900 million people still remain unserved.
To reach the MDG drinking water and sanitation target presents a huge challenge, the report says, adding that the numbers speak for themselves. Achieving the target requires the building of the drinking water infrastructure to provide services to an additional 1.1 billion people and sanitation to an additional 1.6 billion people by 2015.
Considering that two thirds of the time span from the baseline year (1990) to the MDG target has elapsed, business-as-usual is not enough. The world urgently needs to step up activities, increase effectiveness and accelerate investments if the target is to be met.
The report notes that Sub-Saharan Africa is still the main focus of concern. An estimated 80% of people without access to an improved drinking water source live in sub-Saharan Africa, Eastern Asia and Southern Asia. Due to population growth over the period from 1990-2004, the number of people without access to drinking water in Sub-Saharan Africa increased by 23%. Currently, just 56% of the population has access to improved water supply. Just 37% of people in sub-Saharan Africa had access to basic sanitation in 2004, compared to a global average of 59%.
In rural areas, access to improved source of drinking water and to basic sanitation services was very low in 1990 (the baseline year for measuring the MDGs): only an estimated 64% had access to a drinking water source, while 26% had access to sanitation services.
While those percentages rose substantially by 2004 - to 73% and 39% respectively - these numbers still fall way short of what is needed to achieve the MDGs. At a press briefing Tuesday to launch the report, Susanne Weber-Mosdorf, WHO Assistant Director-General, said that the challenge is to keep pace with the rapidly rising global population, especially with the increase in the urban population. There is a need to act now so that the gains and progress previously made in the area of improved access to water are not jeopardized. There is also a need to drastically accelerate access to adequate sanitation, she added.
Maria Neira, WHO Director for Public Health and Environment, said that the data presented in the report is aimed at allowing policymakers to define priority interventions. She also highlighted the phenomenon of massive migration of people from rural to urban areas and a large percentage of people are now living in slums. There is a potential for deterioration in health, as coverage may not be prepared to take into consideration these new populations.
Asked about the privatisation of water and sanitation services and its possible effect on the MDGs, Jose Heub, co-author of the report and just-retired sanitary engineer for the WHO Public Health and Environment Department, said that while privatisation could make a huge difference in the water and sanitation sector, one has to be extremely careful to protect the needs of the poor. If the private sector is to be involved, every effort must be made to protect the poor to enable them to be provided with basic services, he added. Weber-Mosdorf said that for the WHO, access to water and sanitation is a basic human right.
See the joint WHO - UNICEF report on meeting the MDG water and sanitation target
