TWN Info Service on Health Issues (November 06/8)

23 November 2006

Development: Need for global action plan to tackle water and sanitation crisis

Unlike wars and natural disasters, the global water and sanitation crisis does not galvanise international action. This was one of the key messages in the UNDP’s report ‘Human Development Report 2006: Beyond scarcity – Power, poverty and the global water crisis’.

The following article outlines the Report’s concerns and what needs to be done. It is reproduced with the permission of South-North Development Monitor (SUNS) # 6138, 10 November 2006.

With best wishes
Evelyne Hong

Development: Need for global action plan to tackle water and sanitation crisis

By Kanaga Raja, Geneva, 9 November 2006

A Global Plan of Action under G8 leadership is urgently needed to resolve a growing water and sanitation crisis that causes nearly two million child deaths every year, the United Nations Development Programme (UNDP) said Thursday.

This was one of the main messages highlighted in the UNDP's ''Human Development Report 2006: Beyond scarcity - Power, poverty and the global water crisis''. Across much of the developing world, HDR-2006 said, unclean water is an immeasurably greater threat to human security than violent conflict.

According to the report, each year, 1.8 million children die from diarrhoea that could be prevented with access to clean water and a toilet; 443 million school days are lost to water-related illnesses; and almost 50% of all people in developing countries are suffering at any given time from a health problem caused by a lack of water and sanitation.

To add to these human costs, the crisis in water and sanitation holds back economic growth, with sub-Saharan Africa losing five percent of GDP annually or some $28.4 billion - far more than the region receives in aid.

Another key message in the report is that the gap between the richest and poorest countries in the world is growing, as human development in Sub-Saharan Africa stagnates and progress in other regions accelerates.

The report says that unlike wars and natural disasters, the global water and sanitation crisis does not galvanize concerted international action. Like hunger, it is a silent emergency experienced by the poor and tolerated by those with the resources, the technology and the political power to end it. With less than a decade left to reach the Millennium Development Goals (MDGs) by 2015, this needs to change, the report stresses.

"When it comes to water and sanitation, the world suffers from a surplus of conference activity and a deficit of credible action. The diversity of international actors has militated against the development of strong international champions for water and sanitation," said Kevin Watkins, lead author of the report.

"National governments need to draw up credible plans and strategies for tackling the crisis in water and sanitation. But we also need a Global Action Plan - with active buy-in from the G8 countries - to focus fragmented international efforts to mobilize resources and galvanize political action by putting water and sanitation front and centre on the development agenda," he added.

The Action Plan would act as a ''virtual mechanism'', says the report, citing as a useful reference point the Global Fund to Fight AIDS, Tuberculosis and Malaria - all run by a small secretariat with minimal bureaucracy.

In addition to creating a Global Action Plan, the report recommends that the following three foundations are crucial for success:

(1) Make water a human right: The report advocates for all governments to go beyond vague constitutional principles in enabling legislation to ensure the human right to a secure, accessible and affordable supply of water. At a minimum, this implies a target of at least 20 litres of clean water a day for every citizen - and at no cost for those too poor to pay. While a person in the UK or US sends 50 litres down the drain each day by simply flushing their toilet, many poor people survive on less than five litres of contaminated water per day.

(2) Draw up national strategies for water and sanitation: The report urges all governments to prepare national plans for accelerating progress in water and sanitation, with ambitious targets backed with financing to the tune of at least one percent of GDP, and clear strategies for overcoming inequalities. Water and sanitation suffer from chronic under-funding - public spending is typically less than 0.5% of GDP. This figure is dwarfed by military spending - in Ethiopia, for example, the military budget is 10 times the water and sanitation budget, while in Pakistan, it is 47 times.

The report also says that national poverty reduction agendas reflect the pervasive benign neglect of water and sanitation. The sector seldom figures with any prominence in Poverty Reduction Strategy Papers (PRSPs)- the documents that set out national plans and define the terms of cooperation between donors and aid recipients. All PRSPs should include goals and strategies for narrowing extreme disparities in water and sanitation provision, with a special focus on inequalities based on wealth, location and gender.

(3) Increased international aid: The report calls for an extra $3.4 billion to $4 billion annually to have any chance of reaching the MDG on water and sanitation. It states that progress in water and sanitation requires large upfront investments with a very long payback period, so innovative financing strategies like the International Finance Facility are essential. This would be money well-spent, says the report, which estimates the economic return in saved time, increased productivity and reduced health costs at $8 for each $1 invested in achieving the water and sanitation target.

The UNDP estimates the total additional cost of achieving the MDG on access to water and sanitation - to be sourced domestically and internationally - at about $10 billion a year. ''The $10 billion price tag for the MDG seems a large sum - but it has to be put in context. It represents less than five days' worth of global military spending and less than half what rich countries spend each year on mineral water,'' the report argues.

The human development gains would be immense. Closing the gap between current trends and the MDG target on water and sanitation would save more than one million children's lives over the next decade and bring total economic benefits of about $38 billion annually. The benefits for Sub-Saharan Africa - about $15 billion - would represent 60% of its 2003 aid flows.

As it now stands, according to the report, the world is on schedule to reach the MDG on access to water - largely because of strong progress in China and India - but only two regions, East Asia and Latin America, are on track for sanitation. But this picture masks some real problems - on current trends, sub-Saharan Africa will reach the water target in 2040 and the sanitation target in 2076. For sanitation, South Asia is four years off track, and for water, the Arab States are 27 years off track.

Measured on a country-by-country basis, this means that 234 million people will miss the water target, with 55 countries off track, and 430 million people will not reach the sanitation target, with 74 countries off track. For Sub-Saharan Africa to get on track, connection rates for water will have to rise from 10 million a year in the past decade to 23 million a year in the next decade.

The MDG target for water and sanitation is in respect of halving the proportion of the world population without sustainable access to safe drinking water and basic sanitation by 2015. Even if the targets are achieved, there will still be more than 800 million people without water and 1.8 billion people without sanitation in 2015, says the report.

"Can the world afford to meet the costs of accelerated progress towards water and sanitation provision?" asks report author Watkins. "The more appropriate question is: Can the world afford not to make the investments?"

More than 2.6 billion people still lack access to proper sanitation, and 1.1 billion people have no regular access to clean water.

While basic needs vary, the minimum threshold (of water use) is about 20 litres a day. Most of the 1.1 billion people categorized as lacking access to clean water use about 5 litres a day - one-tenth of the average daily amount used in rich countries to flush toilets. On average, people in Europe use more than 200 litres, while people in the United States use more than 400 litres.

There is more than enough water in the world for domestic purposes, for agriculture and for industry, says the report. The problem is that some people - notably the poor - are systematically excluded from access by their poverty, by their limited legal rights or by public policies that limit access to the infrastructures that provide water for life and for livelihoods.

Almost two in three people lacking access to clean water survive on less than $2 a day, with one in three living on less than $1 a day. More than 660 million people without sanitation live on less than $2 a day, and more than 385 million on less than $1 a day.

The toilet may seem an unlikely catalyst for human development, but the report provides powerful evidence to show how it benefits people's well-being. Research shows that in Peru, access to a flush toilet reduces the risk of infant death by 59%, compared with an infant in a household without adequate sanitation. Similarly, in Egypt, data show the risk of infant death plummeting by 57% in households with toilets.

The report also finds that across the world, the poor are forced to pay much more for clean water than their affluent neighbours.

People living in the slums of Jakarta, Indonesia; Manila, the Philippines; and Nairobi, Kenya, pay 5-10 times more for water per unit than those in high-income areas of their own cities - and more than consumers pay in London or New York. The poorest 20% of households in El Salvador, Jamaica and Nicaragua spend on average more than 10% of their household income on water. In the United Kingdom, by contrast, spending more than three percent of family income on water is considered an economic hardship.

While the rich usually get water from a single supplier, the poor have to reckon with a bewildering array of service providers, such as public stand-pipes, vendors, truckers, and water carriers. Some of the water vendors access water from the municipal source and then re-sell it at a premium to poor slum dwellers who do not have access to piped water. As a result, water delivered through a vendor is often 10 to 20 times more costly than water provided by the public utility.

According to the report, the longstanding public-versus-private debate on water will not bring prices down. In recent years, public debate on water-delivery policy in developing countries has been dominated by a polarizing discussion on privatization versus public ownership.

"The debate over the relative merits of public and private-sector performance has been a distraction from the inadequate performance of both public and private water providers in overcoming the global water deficit," says the report. A new, more strategic approach that puts the poor at the centre of the solution is essential to reach the Millennium Development Goals by 2015.

Some privatization programmes have produced positive results. But the overall record is not encouraging, says the report.

From Argentina to Bolivia, and from the Philippines to the US, the conviction that the private sector offers a "magic bullet" for unleashing the equity and efficiency needed to accelerate progress towards water for all has proven to be misplaced. While these past failures of water concessions do not provide evidence that the private sector has no role to play, they do point to the need for greater caution, regulation and a commitment to equity in public-private partnerships.

Two specific aspects of water provision in countries with low coverage rates caution against an undue reliance on the private sector. First, the water sector has many of the characteristics of a natural monopoly. In the absence of a strong regulatory capacity to protect the public interest through the rules on pricing and investment, there are dangers of monopolistic abuse.

Second, in countries with high levels of poverty among unserved populations, public finance is a requirement for extended access regardless of whether the provider is public or private.

Public providers dominate water provision, accounting for more than 90% of the water delivered through networks in developing countries. Many publicly owned utilities are failing the poor, combining inefficiency and un-accountability in management with inequity in financing and pricing, according to the report. But some public utilities - Porto Alegre in Brazil is an outstanding example - have succeeded in making water affordable and accessible to all.

While the number of people served by private water companies has grown - from about 51 million in 1990 to nearly 300 million in 2002 - public water companies account for more than 70% of total investment globally, and fewer than 3% of people in developing countries receive water or sanitation services that are fully or partially private.

There are now real opportunities to learn from failures and build on successes, says the report. The criterion for assessing policy should not be public or private but performance or non-performance for the poor. Some countries have registered rapid progress in water provision. From Colombia to Senegal and South Africa innovative strategies have been developed for extending access to poor households in urban areas.

The report advocates for all governments to go beyond vague constitutional principles in enabling legislation to ensure the human right to a secure, accessible and affordable supply of water.

The report, amongst others, stresses that contract arrangements under public-private management agreements should set clear goals for expanding access for poor households living in slums. Non-performance should result in financial penalties. The same rules should apply to public providers, with non-performance penalized through incentive systems.

Lifeline tariffs would allow poor households to access a minimum amount of water for a very low price or no charge, with usage fees rising thereafter. South Africa has already legislated that every person should have a minimum of 25 litres of clean water each day.

Creating an independent regulator to oversee water providers - including the intermediaries that serve the poor - is vital for ensuring that water provision reflects the public interest. Subsidies can play a critical role in delivering affordable water to the poor, but too often, they instead deliver windfalls to the non-poor, while impoverished households using public taps face the highest prices. Using cross-subsidies - a combination of pricing and access policies, including targeted subsidies - to support standpipe users where coverage rates are low would be a step towards improved equality.

The report also says that poor farmers face a potentially catastrophic water crisis from the combination of climate change and competition for scarce water resources. Intensifying competition for water is now one of the gravest threats to sustained human development. Rising industrial demand, urbanization, population growth and pollution are placing unprecedented stress on water systems - and on agriculture.

As competition intensifies, social conflict over water is likely to increase. The danger is that those with the weakest rights - small farmers and women producers in particular - will lose out. The great majority of the world's malnourished people -estimated now at 830 million - are small farmers, herders, and farm labourers.

Climate change also threatens to intensify water insecurity on an unparalleled scale. Even with an agreement to mitigate carbon emissions through international cooperation, dangerous climate change is now almost inevitable, and the most severe consequences will be experienced by countries and people who bear no responsibility for the problem. Parts of sub-Saharan Africa are facing crop losses of up to 25% from climate-change-induced weather patterns. Meanwhile, accelerated glacial melt and reduced rainfall threaten major food systems in South Asia.

The report calls for securing rights to water to give poor people opportunities to escape poverty. To maintain human progress, governments must recognize, extend and protect the water rights of the rural poor.

Efforts thus far to help the poor to adapt to climate change have been 'spectacularly inadequate,' says the report. Agriculture will be the hardest hit. In some regions, changing rainfall patterns and declining water availability will reduce yields by a quarter or more by 2050. Global malnutrition could increase by 15-26%, says the report, with 75 to 125 million more people facing malnourishment by 2080.

International aid for adaptation ought to be a cornerstone of multilateral action on climate change, yet aid transfers have been woefully inadequate, says the report. The Adaptation Fund attached to the Kyoto Protocol will mobilize only about $20 million by 2012 on current projections, while the Global Environmental Facility - the principal multilateral mechanism for adaptation - has allocated $50 million to support adaptation activities between 2005 and 2007.

The need for increasing cooperation across national borders to ensure water security for the poor is more tangible than ever, because by 2025, over three billion people could be living in countries under water stress.

The report identifies two broad objectives in transboundary water governance: replacing unilateral action with multilateral cooperation, and putting human development concerns, not power and politics, at the centre of the debate. Getting there will require backing away from rigid sovereignty claims, strengthening political leadership, and finding a better balance of power.

The report also notes that developing countries as a group have seen aid to agriculture fall from 12% to 3.5% of total aid since the early 1990s. Reversing these trends will be critical to successful adaptation. Tripling aid to agriculture - from $3 billion annually to $10 billion by 2010 - should be a minimum requirement.

The report finds that countries at the top and bottom of the rankings in this year's report remain unchanged from last year - Norway ranks highest, while Niger is last of the countries for which sufficient information is available. People in Norway are more than 40 times wealthier than people in Niger and they live almost twice as long.

As to the entrenched inequality across the globe, the report finds for example that the combined income of the 500 richest people in the world now exceeds that of the poorest 416 million people.

One of the central human development challenges ahead is to diminish tolerance for the extreme inequalities that have characterized globalization since the early 1990s, and to ensure that the rising tide of prosperity extends opportunities for the many, and not just the privileged few, the report stresses.