UN report warns that poor water supply continues to pose major health threatBMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7389.568/b (Published 15 March 2003) Cite this as: BMJ 2003;326:568
More than two million people—many of them children—die every year from diarrhoea and a range of other conditions associated with poor water and sanitation, a report from the United Nations has said.
The first UN world water development report, to be launched on 22 March, argues that one of the biggest threats to health remains lack of water and poor sanitation. It estimates that 1.1 billion people have seen no improvement in their water supplies beyond a basic minimum and that 2.4 billion do not have adequate sanitation. As a result, a million people die of malaria each year, and another two billion people are infected with schistosomes and other helminths, 300 million of them becoming seriously ill.
The report is part of an ongoing assessment project to measure progress towards the goal of sustainable development formulated at the 1992 Earth Summit in 1992 and the targets set down in the UN Millennium Declaration of 2000. These pledged to halve by 2015 the proportion of people who can't reach or afford safe drinking water and to stop the unsustainable exploitation of water resources by developing water management strategies at regional, national, and local levels that promote equitable access and adequate supplies.
The report gives a bleak picture of increasing problems, failed targets, and poor resource management—all contributing to an overwhelming burden of death and disease in the countries that are least equipped to deal with the problems. The report states: “This crisis is one of water governance, essentially caused by the ways in which we mismanage water. But the real tragedy is the effect it has on the everyday lives of poor people, who are blighted by the burden of water-related disease, living in degraded and often dangerous environments, struggling to get an education for their children and to earn a living, and to get enough to eat. The brutal truth is that the really poor suffer a combination of most, and sometimes all, of the problems in the water sector.”
The tragedy, the report points out, is that much of the disease burden is largely preventable through better access to safe drinking water and sanitation. If improved water supplies and basic sanitation were extended to people who currently lack such services, argue the authors, the burden of infectious diarrhoea would be reduced by around 17% a year. Universal piped water and full sanitation would reduce the burden by 70%. Over the past three decades many targets have been set, but the report says there has been a consistent pattern of failure in achieving them.
The report suggests that reform and liberalisation of the water sector, better valuation of water, and greater involvement of the private sector could bring forward new technology and ways of operating that “could enable us to muddle through.™ But it adds: “This is to take an optimistic view. The realist would have to say that, on the basis of the evidence put forth by this first World Water Development Report, the prospects for many hundreds of millions of people in the lower income countries, as well as for the natural environment, do not look good.”
Water for People, Water for life is available for free in summary form or the full report can be ordered (price ‡49.95 or £49.95) from www.unesco.org/water/wwap/wwdr/index.shtml