ISBN 92 4 156293 5 - World Health Organization

1 isbn 92 4 156293 5 OMS-Water for life-COUV 15/06/05 10:40 Page 1 Photo creditsWHO PhotolibraryP. Steeger/Masterfile (dripping water faucet on cover)ILO (image of well on cover background)OMS-Water for life-COUV 15/06/05 10:41 Page 2 WATE R FO RLIFEMAKING IT HAPPENOMS-Water for life-INT 14/06/05 10:41 Page iDECADE FOR ACTION 2005 2015 WHO Library Cataloguing-in-Publication DataWHO/UNICEF Joint Monitoring Programme for Water Supply and for life : making it supply water supply and distribution 92 4 156293 5(NLM classification: WA 675) World Health Organization and UNICEF, 2005 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization , 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476;fax: +41 22 791 4857; email: Requests for permission to reproduce or translate WHOpublications whether for sale or for noncommercial distribution should be addressed to WHO Press, at theabove address (fax: +41 22 791 4806; email: designations employed and the presentation of the material in this publication do not imply the expressionof any opinion whatsoever on the part of the World Health Organization or UNICEF concerning the legalstatus of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers orboundaries.))

2 Dotted lines on maps represent approximate border lines for which there may not yet be mention of specific companies or of certain manufacturers products does not imply that they areendorsed or recommended by the World Health Organization or UNICEF in preference to others of asimilar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products aredistinguished by initial capital reasonable precautions have been taken by the World Health Organization and UNICEF to verify the infor-mation contained in this publication. However, the published material is being distributed without warranty ofany kind, either express or implied. The responsibility for the interpretation and use of the material lies with thereader. In no event shall the World Health Organization or UNICEF be liable for damages arising from its in FranceDesign and layout: L IV Com S rl, Morges, SwitzerlandiiOMS-Water for life-INT 14/06/05 10:41 Page iiWATE R FO RLIFEMAKING IT HAPPEN1 CONTENTSF oreword2 Welcome to the action decade4 Par t 1 Water for life and for living lifelong10 Par t 2 Making it happen23 Find out more about the action decade34 Tapping the sources35 Annex 1 Meeting the MDG drinking water and sanitation target what increase is needed?

3 36 Annex 2 Regional and global drinking water and sanitation coverage estimates37 OMS-Water for life-INT 14/06/05 10:41 Page 1 DECADE FOR ACTION 2005 20152 FOREWORDE very day, diarrhoeal diseases from easily preventa-ble causes claim the lives of approximately 5000young children throughout the World . Sufficient andbetter quality drinking water and basic sanitation cancut this toll dramatically, and simple, low-cost house-hold water treatment has the potential to savefurther we enter the International Decade for ActionWater for Life2005 2015, this report makes clearthat achieving the target of the MillenniumDevelopment Goals (MDGs) for access to safedrinking water and basic sanitation will bring a pay-back worth many times the investment involved. Itwill also bring Health , dignity and transformed livesto many millions of the World s poorest people.

4 Thehumanitarian case for action is blindingly economic case is just as water and sanitation will speed theachievement of all eight MDGs, helping to: eradicateextreme poverty and hunger ; achieve universalprimary education; promote gender equality andempower women; reduce child mortality; improvematernal Health ; combat HIV/AIDS, malaria andother diseases; ensure environmental sustainability;and develop a global partnership for US$ billion a year, the dollar costs of achiev-ing the MDG drinking water and sanitation targetare affordable; the human costs of failing to do soare not. The International Decade for Action Waterfor Lifeprovides the incentive for coordinatedefforts to prevent the daily disaster of for life-INT 14/06/05 10:42 Page 2 OMS-Water for life-INT 14/06/05 10:42 Page 3 DECADE FOR ACTION 2005 20154 WELCOME TO THE ACTION DECADEW orld Water Day, 22 March 2005, heralded thestart of the International Decade for Action pro-claimed by the United Nations General for Lifecalls for a coordinated responsefrom the whole United Nations system.

5 The timing issignificant: the end of the action decade in 2015 isthe target date for achievement of many of theMillennium Development Goals (MDGs). Thosegoals were amplified by the 2002 World Summit onSustainable Development in the Johannesburg Planof Implementation, which set the following , BY 2015, THE PROPORTION OF PEOPLEWITHOUT SUSTAINABLE ACCESS TO SAFE DRINKINGWATER AND BASIC is not hard to see why providing access to safedrinking water and basic sanitation for the World smost deprived populations is moving up the politicalagenda. With billion people recorded as lackingany improved sanitation facilities in 2002 and bil-lion of them without access to an improved drinkingwater source, the resulting squalor, poverty and dis-ease hold back so many development efforts on achievement of the MDG drink-ing water and sanitation target will speed progresstowards all eight increasing reliability of coverage data hasenabled the WHO/UNICEF Joint MonitoringProgramme for Water Supply and sanitation (JMP)and others to link access to improved drinkingwater sources and improved sanitation with Health ,economic and human development statistics.

6 Agrowing portfolio of case studies from around theworld helps to demonstrate the beneficial effectsof improved drinking water and sanitation . Relatingcoverage and diarrhoeal disease prevalence showsthat meeting the MDG target would avert 470thousand deaths and result in an extra 320 millionproductive working days every year. Economicanalyses are showing that the benefits on investmentto achieve the target would be on the region of the World , economicbenefits can be valued to range from US$ 3 toUS$ 34 for each dollar the International Decade for Action, we need tofind ways of replicating successful actions and insti-gating many more that will bring improved waterand sanitation services to all those in first part of this report charts the effect thatlack of drinking water and sanitation has on people slives at different stages (childhood, adolescence,adulthood and old age), highlighting the genderdivide and threat posed by HIV/AIDS.

7 The secondpart looks at a range of interventions that are beingadvocated and analyses their potential impact onprogress towards the MDG drinking water andsanitation help you to find out more about the actiondecade, the report lists web pages that provide back-ground reference is also a list of themain agencies that provide advocacy and technicalsupport in the water, sanitation and hygiene report concludes with statistical tables showingthe increase needed to achieve the MDG drinkingwater and sanitation target (Annex 1) and drinkingwater and sanitation coverage estimates at regionaland global level (Annex 2).INVESTING IN DRINKING WATER AND SANITATIONThe estimated economic benefit comes in several forms: Health care savings of US$ 7 billiona year for Health agencies and US$ 340 millionfor individuals. 320 million productive days gained each year in the 15 59 year age group, an extra 272 million schoolattendance days a year, and an added billion healthy days for children under 5 years of age, togetherrepresenting productivity gains of US$ billiona year.

8 Time savings resulting from more convenient drinking water and sanitation services totalling 20 billion work-ing days a year, giving a productivity payback of some US$ 63 billiona year. Value of deaths averted, based on discounted future earnings, amounting to US$ billiona WHO study from which these figures are taken shows a total payback of US$ 84 billiona year from theUS$ billion a year investment needed to meet the MDG drinking water and sanitation target. It shows toosome remarkable additional returns if simple household water treatment accompanies the drinking water andsanitation improvements. Source: Evaluation of the costs and benefits of water and sanitation improvements at the global , World HealthOrganization, EIGHT MILLENNIUM DEVELOPMENT GOALS Eradicate extreme hunger and poverty Achieve universal primary education Promote gender equality and empower women Reduce child mortality Improve maternal Health Combat HIV/AIDS, malaria and other diseases Ensure environmental sustainability Develop a global partnership for developmentOMS-Water for life-INT 14/06/05 10:42 Page 4020406080100 WATE R FO RLIFEMAKING IT HAPPEN5 DRINKING WATER AND sanitation .

9 A FORMIDABLE CHALLENGEThe charts of drinking water and sanitation coveragein Figures 1 and 2 remind us of the huge progressmade from 1990 to show also that toomany people in the World still live in squalid, demean-ing conditions that rob them of dignity and the meansto escape from 2002, there were billion people without eventhe most basic sanitation facilities. Providing improvedsanitation for an additional billion from 2002 to2015 will achieve the MDG target to halve the pro-portion unserved by 2015. But, because of rising pop-ulation, there will still be billion people having tocope with unhygienic sanitation facilities at that population benefiting from improved sanitationwent up by 87 million a year from 1990 to increase to 138 million a year from 2002 to2015 is needed if the MDG sanitation target is to bemet a 58% acceleration.

10 Sub-Saharan Africa willneed almost to double the annual numbers of addi-tional people served with drinking water and quad-ruplicate the additional numbers served with basicsanitation if the MDG target is to be reached. So,reaching the target means going faster and investingconsiderably more. That is being recognized by theworld community in political proclamations and inincreased commitments to the sector in some ofthe poorest countries. There is a strong case to doeven of drinking water and sanitation kills about4500 children a day and sentences their siblings,parents and neighbours to sickness, squalor andenduring poverty. Improvements bring immediateand lasting benefits in Health , dignity, education,productivity and income 1 Drinking watercoverage by region in1990 and 2002 Coverage (%)Northern Africa Latin America/Caribbean Western Asia South Asia South-Eastern Asia Eastern Asia Sub-Saharan Africa Oceania Developed Countries Eurasia Developing Countries World Coverage (%)19902002 Figure 2 sanitation coverageby region in1990 and 2002199020028389838873797278495851529293 717977831009871848890020406080100 Western Asia Latin America/Caribbean Northern Africa South-Eastern Asia Oceania Eastern Asia South Asia Sub-Saharan Africa Developed Countries Eurasia Developing Countries World 6975657358552445203732368483344949581009 848617979 OMS-Water for life-INT 14/06/05 10.