Info Service on Health Issues (November 06/8)
Development: Need for global action plan to tackle water and sanitation
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’.
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.
Development: Need for
global action plan to tackle water and sanitation crisis
By Kanaga Raja, Geneva, 9
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)
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
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
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
(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
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
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.
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