Intended for healthcare professionals


Worldwide water crisis is a “silent emergency,” UN agency says

BMJ 2006; 333 doi: (Published 09 November 2006) Cite this as: BMJ 2006;333:986
  1. Peter Moszynski
  1. 1London

Unclean water is an “immeasurably greater threat to human security than violent conflict” across the developing world, says the latest annual report from the United Nations Development Programme.

The report says, “‘Not having access to clean water' is a euphemism for profound deprivation. It means that people walk more than one kilometre to the nearest source of clean water for drinking, that they collect water from drains, ditches or streams that might be infected with pathogens and bacteria that can cause severe illness and death.”

Each year 1.8 million children die from diarrhoea that could be prevented; 443 million school days are lost to water related illnesses; and almost 50% of all people in poor countries have at any given time a health problem caused by a lack of water and sanitation.

The report claims that the crisis in water and sanitation holds back economic growth, with sub-Saharan Africa losing 5% of gross domestic product annually—far more than the region receives in aid.

Although climate change is already affecting sub-Saharan Africa, as evidenced by the recent droughts and floods in Ethiopia and the Horn of Africa, the report insists that the water crisis is largely “due to mismanagement rather than scarcity.”

Inadequate water and sanitation cause more deaths than violent conflict. However, unlike wars and natural disasters this “global crisis” fails to galvanise 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.”

Worldwide 1.1 billion people still lack access to clean water and 2.4 billion lack adequate sanitation. While each person in the United Kingdom or the United States sends 50 litres down the drain each day simply by flushing the toilet, many poor people survive on less than 5 litres of contaminated water a day, says the report.

Kevin Watkins, the report's lead author, said, “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.

“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 mobilise resources and galvanise political action by putting water and sanitation front and centre on the development agenda.”

The report says that an international mechanism should be set up, similar to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which would be run by a small secretariat with minimal bureaucracy, and it calls for access to safe water to be considered as an essential human right. “Everyone should have at least 20 litres of clean water per day, and the poor should get it for free,” the report says.


  • Beyond Scarcity: Power, Poverty and the Global Water Crisis is available at

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