Policy Brief

January 2011

Water, Sanitation, and Hygiene in Development
Problem
Water, sanitation and hygiene (WASH) underlies the success of virtually all aspects of development. Inadequate access to safe water and sanitation services, coupled with poor hygiene practices, kills and sickens thousands daily and leads to impoverishment and diminished opportunities for thousands more. Meaningful progress on WASH has been limited by lack of capacity and strategic leadership and diverging political priorities.

Recommendations & Actions
The Administration and Congress must prioritize and integrate WASH in its overall approach to international development. This includes: creating a multi-year WASH strategy that targets programs based on need, as required by the 2005 Senator Paul Simon Water for the Poor Act; the integration of WASH into presidential international development initiatives; and increasing the capacity within USAID and the Department of State to implement WASH programs. • The Administration should develop a comprehensive, multi-year WASH strategy, integrated within a wider water strategy including water resources management and water productivity with measureable indicators, benchmarks and a timetable. Develop the strategy using meaningful consultation with relevant stakeholders, including civil society. • Congress and White House officials should work together to ensure full funding of such a strategy. • USAID should integrate WASH planning and budgeting into the broader development agenda, particularly into the presidential initiatives on global health, food security and climate change. • The Administration and Congress should take the level of need into account when targeting WASH funding. According to relevant international donor guidelines, 70 percent of WASH aid should target low-income countries. • To increase capacity, the Administration should have senior WASH advisers at both the Department of State and USAID in order to increase inter-agency coordination and demonstrate U.S. leadership both domestically and with international stakeholders. USAID should continue training personnel in WASH issues to develop long-term expertise. • The Administration should support and participate in the Sanitation and Water for All (SWA) partnership to address gaps in policy, planning, financing and technical assistance. • USAID should undertake an evaluation of the extent to which the funding in furtherance of the Senator Paul Simon Water for the Poor Act has achieved its objectives, including the requirement that funds be distributed fairly between rural, peri-urban and urban areas.

Results
A strong strategy and increased staffing will give the U.S. Government the tools it needs for robust leadership on safe, affordable and sustainable access to water and sanitation globally. Integrating WASH into other U.S. development programs will help to ensure their success. Improved coordination among donors will support recipient governments in their efforts to achieve universal WASH access, which will ultimately produce healthier, more stable societies with stronger economic growth.

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Background
Water, sanitation and hygiene (WASH) are crucial building blocks for development. They improve the quality of life and health, advance education, reduce poverty and malnutrition, increase child and maternal survival, drive economic growth and contribute to gender equality and dignity. Despite the importance of WASH in virtually all development outcomes, an estimated 884 million people still lack access to safe drinking water, and 2.6 billion lack basic sanitation.1 With the 2015 deadline for the Millennium Development Goals (MDGs) quickly approaching, addressing WASH issues is particularly critical to accelerate progress on all of the MDGs. Water and sanitation is perhaps the world’s largest single cause of disease. More than 25 diseases are caused by inadequate water and sanitation, creating nearly 10 percent of the global public health burden, killing more than 2 million people each year (including more children than AIDS, tuberculosis and malaria combined)2 and leading to 50 percent of the world’s malnutrition.3 The cost of failing to properly address the gaps in safe water and sanitation is significantly higher than the cost of addressing them. Every year, lack of water and sanitation costs sub-Saharan Africa around $23.5 billion, or 5 percent of its GDP.4 Investments in water and sanitation are costeffective, with an estimated $8 returned for every dollar invested.5 Safe water and improved sanitation provides a basic level of human security that, once reached, enables families and individuals to work to increase their standards of living, educate their children and become better stewards of the environment. Water is also a growing strategic issue whose provision increases the likelihood of peaceful solutions to resource allocation concerns (e.g. in water-stressed and arid areas). The good news is that 87 percent of the world’s population has access to safe, affordable and sustainable drinking water, while 61 percent has access to improved sanitation.6 This indicates enormous progress due to the collective efforts of governments, businesses, foundations and non1 2010 WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation, http://www.wssinfo.org/en/welcome.html 2 http://www.wateradvocates.org/media/nytimesads/Sources.pdf 3 WHO, Safer Water, Better Health, http://whqlibdoc.who.int/publications/2008/9789241596435_eng.pdf 4 UNDP, Human Development Report 2006. http://hdr.undp.org/en/media/HDR06-complete.pdf 5 WHO (2004) Evaluation of the costs and benefits of water and sanitation improvements at the global level, by Hutton and Haller - http://www. who.int/water_sanitation_health/wsh0404/en/ 6 Improved sanitation ensures that human waste is hygienically separated from human contact. 2010 WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation, http://www.wssinfo. org/en/welcome.html

governmental organizations. In short, effective and appropriate solutions to the global water and sanitation problem are proven and are available. The most sustainable ones include not just water supply solutions (e.g. boreholes, rainwater harvesting) but also sanitation provisions (e.g. pit latrines) and hygiene training to promote frequent hand washing. The biggest challenges to achieving universal access to safe water and sanitation and good hygiene are a lack of global awareness of the issue, a lack of operational scale in the sector and a lack of the collective political will needed to properly and quickly channel the necessary financial, human and technical resources. Other significant challenges include developing culturally-appropriate strategies to promote needed behavior changes, as well as improved management systems and governance. Environmental degradation and finite water resources limit the ability to expand water supplies indefinitely. Policy changes that promote conservation and set more appropriate water use rates are also essential to sustainability. Although developing countries bear most of the responsibility for funding water and sanitation improvements in their countries, the developed world can and should offer financial, human and technical assistance to speed up and support this ongoing process. Congress has shown strong leadership on WASH issues by creating the Senator Paul Simon Water for the Poor Act in 2005.7 This act, passed with overwhelming bipartisan support, made the provision of safe drinking water and sanitation in countries of greatest need a priority of U.S. foreign policy. The State Department and USAID also increasingly recognize the importance of WASH to international development outcomes and U.S. national security. In her 2010 World Water Day speech, Secretary of State Hillary Clinton said, “Water represents one of the great diplomatic and development opportunities of our time. It’s not every day you find an issue where effective diplomacy and development will allow you to save millions of lives, feed the hungry, empower women, advance our national security interest, protect the environment, and demonstrate to billions of people that the United States cares, cares for you and your welfare. Water is that issue.”8 As the international community works toward the MDG target of halving the number of people without safe water and sanitation, both developing and developed countries must increasingly prioritize the provision of safe water and adequate sanitation. Safe drinking water and sanitation are not a luxury. Without them, progress on other development priorities cannot be sustained.9
7 The Senator Paul Simon Water for the Poor Act of 2005, P.L. 109-121, http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=109_ cong_public_laws&docid=f:publ121.109.pdf 8 http://www.state.gov/secretary/rm/2010/03/138737.htm 9 Kyoto Water Forum, “The Contribution of Water for Achieving the MDGs” http://www.unsgab.org/docs/biblioteca/I-1.12.pdf

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