Lack of access to clean drinking water is the biggest problem facing the developing world. Charities and NGOs simply do not have enough clout to tackle the problem.
One in five people in the world don’t have access to clean water. And half of us have no sanitation. This leads to constant ill health – millions of children still die from diarrhoea. It means hours of toil for women and girls who are constantly weary, walking miles to fetch water. Girls miss out on school and lack of sanitation leads to humiliation and ill health.
The answer is not more charity or NGO projects. Water and sanitation are not a matter for charity. They are essential for human health and development. If we look back to Birmingham in the 1820’s, in the early days of industrialisation, we find child labour, illiteracy, disease and low life expectancy. The big uplift in health and survival came as engineers built systems that provided water and sanitation. This was even more important that improvements in health care. The developing world needs the same. Thousands of water pumps have been provided without the spares or expertise for maintenance. Inevitably, they break down and fall into disuse, thus generating cynicism about the usefulness of aid. Hundreds of miles of pipes have been laid without systems to pay or employ people to maintain them and inevitably such systems fail and crumble. Well-intentioned projects funded by short term aid are recipes for constant failure.
In many very poor countries, the slum dwellers pay large sums for water delivered by the bucket and the elite receive water at highly subsidised rates provided by publicly owned water companies. And yet, when the World Bank tries to support – say, Ghana – in working out how it might provide and fund water and sanitation services for all its people, NGOs raise bitter campaigns about the immorality of reform which they denounce – inaccurately – as privatisation.
Most of those who join these arguments mean well, but there is a deep paternalism in the attitudes they bring. If we examine our own history or that of the countries that have succeeded in bringing development and improved services to their people, they would adjust their outlook. Developing countries need sustainable systems that can provide and maintain services for their people. Water is needed for human consumption and also for agriculture. Sanitation requires major investment. We need therefore to concentrate on sharing expertise, using aid to speed up investment in sustainable systems and to encourage regulatory arrangements that deliver equitable services that make reasonable charges and ensure services are provided to the poor. There are very rich elites in developing countries. They tend to control the State and bend the public services to their own advantage. Defending inefficient and inequitable public services does not help the poor. . In fact, water related diseases are the single largest source of sickness and death in the world and disproportionately affect poor people.
Improved water and sanitation services are crucial to improved health. Recent research also shows a strong interaction between health and development. The poor are not a constant group of people. The poor of the world work enormously hard. They constantly improve their lives through their own creativity and hard work. But ill health is a major barrier to the improvement of their lives. Easily preventable and curable illnesses like malaria, TB, diarrhoea cause enormous burdens of ill health. A breadwinner who falls ill throws a whole family into poverty. The ill health of children leads to the spending of savings and the sale of animals and tools thus reducing families to penury. Investment in sustainable systems to provide water and sanitation to all enhance human dignity and economic development.
There has been an important advance in recent years in the way support for development is organised. In the past, large numbers of donors funded a proliferation of projects – large and small. The consequence of this was often a hollowing out of state capacity, as finance ministries spent their time dealing with aid missions, aid accounts and evaluations and educated staff were poached from government service for better paid jobs working for aid agencies. Thus useful projects were provided, but they tended to collapse when aid funds ceased to flow. The new development framework requires countries to put in place strategies for managing the economy and funding public services in a way which will measurably reduce poverty.
Significant progress has been made in many countries in improving economic growth and the provision of health and education. Few of these strategies have, up until now, made provision for a systematic expansion of water and sanitation services. An effort is needed now to explicitly include plans for expanding water and sanitation services in all poverty reduction strategies and identifying funds for investment and training so that services are systematically expanded and are sustainable. This approach does not meant that it is desirable that all services should be provided by the state. On the contrary, the investment required means that partnerships with the private sector, aid agencies, and NGOs are highly desirable, but the partnerships must be co-ordinated in order that the expansion of services can reach the scale needed to provide for all and give the poor a chance to lift themselves out of poverty.
Current projections are that two thirds of countries will face severe water strain by 2025. This will lead to considerable suffering and ill health and an increasing risk of conflict over water both within and between states. At the Johannesburg UN Summit on Sustainable Development in September 2002, strong commitments were made to expand provision of water and sanitation services to the poor. Now is the time to deliver on that promise.