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Providing toilets, safe water is top route to reducing world poverty: UN University

Simply installing toilets where needed throughout the world and ensuring safe water supplies would do more to end crippling poverty and improve world health than any other possible measure, according to an analysis released today by the United Nations University.

The analysis says better water and sanitation reduces poverty in three ways.

  • New service business opportunities are created for local entrepreneurs;
  • Significant savings are achieved in the public health sector; and
  • Individual productivity is greater in contributing to local and national economies.

UNU also calls on the world's research community to help fill major knowledge gaps that impede progress in addressing the twin global scourges of unsafe water and poor sanitation.

Information gaps include such seemingly obvious measures as common definitions and worldwide maps to identify communities most vulnerable to health-related problems as a result of poor access to sanitation and safe water. UNU also calls for creation of a "tool-box" to help policy-makers choose between available options in local circumstances.

"Water problems, caused largely by an appalling absence of adequate toilets in many places, contribute tremendously to some of the world's most punishing problems, foremost among them the inter-related afflictions of poor health and chronic poverty," says Zafar Adeel, Director of the UN University's Canadian-based International Network on Water, Environment and Health.

"It is astonishing that, despite all the attention these issues have received over decades, the world has not even properly mapped water and sanitation problems nor agreed on such terms as 'safe,' or 'adequate,' or 'accessible' or 'affordable,' all of which are in daily use by officials and policy-makers."

In the analysis, prepared for global policy makers and released Oct. 20 at the start of a two-day UNU-hosted international meeting in Hamilton, Canada, experts offer a prescription for policy reform.

Based on input of experts from several countries convened in Canada late last year, the analysis urges governments to adopt a more coordinated, integrated and interlinked approach to dealing with water and sanitation problems. Such efforts must be included in national economic development plans.

The UNU analysis identifies population growth, poverty, climate change, globalization and inappropriate policies on investment, urbanization, and intensification of agriculture as the five global trends most likely to exacerbate water supply and sanitation problems in years to come.

"The UN's Millennium Development Goal, agreed in the year 2000, committed nations to halve by 2015 the number of people who lack safe water and adequate toilet facilities," says Dr. Adeel, who will chair the meeting.

"As the International Year of Sanitation winds down, UNU invites and welcomes the help of all scientists who agree we can and must do more," says Prof. Susan Elliott, a Senior Research Fellow at UNU-INWEH and a professor at McMaster University.

"Poor health, especially chronic illness, can force a household below the poverty threshold," the analysis says.

This becomes self-perpetuating as a poverty-stricken household is more prone to ill health. Low education levels and lack of knowledge further maintain this cycle, as understanding links between hygiene and waterborne diseases tend to come more easily to households with higher education levels.

The results are significant, especially for women and girls, improving household health, reducing the time spent to collect water and providing a safe and dignified environment for practising sanitation. This means that there is more time to tend to crops and livestock, more time and resources to spend on improved food preparation, more time to attend school and, an opportunity to participate in the local economy; all mechanisms which work towards breaking the cycle of poverty.

The analysis warns that microbial and chemical contamination of water and other new threats are emerging from pharmaceuticals in drinking water to exposure to avian influenza brought by wild birds inhabiting wetlands.

The "toolbox" idea would involve "a virtual library and database of educational materials, technologies, governance, models, etc. would facilitate information exchange of both established and innovative tools."

"We need greater investment in the development of models to aid decision-making, reduce uncertainty and augment costly monitoring programmes," says Dr. Corinne Wallace, a leading water-health researcher at UNU-INWEH. "Combining these efforts with a vulnerability map for water-associated diseases can form the basis for evidence-based policy development," she adds.

As well, "validated models need to be developed that will predict the impact of climate change on water and wastewater infrastructure, water availability, water quality and waterborne / water-associated diseases."

The results can be used for policy development, intervention, adaptation and mitigation purposes as well as the effect on achieving MDGs and global migration patterns.


Diseases due to poor water, sanitation and hygiene account for an estimated 10% of the total global burden of illness.

An investment by developed countries estimated at US 4c per capita per day would allow the developing world to reach the UN's Millennium Development Goal for water and sanitation by 2015.

Simply improving domestic water supply, sanitation and hand washing with soap can reduce illness rates by more than 25%.

Globally, almost 900 million people lack access to safe water supplies and 2.5 billion people live without access to improved sanitation, at least 80% of whom live in rural areas.

In 2002, the total number of deaths attributed to poor water, sanitation and hygiene was over 3.5 million.

Each year, estimated 4 billion people contract diarrhoeal diseases.

Some 1.4 million children (half a million of them under age 5) die as a result of diarrhea. Chronic diarrhoea can also result in child malnutrition, making them susceptible to other diseases and resulting in 860,000 deaths per year.

Some 94% of diarrhoea cases are preventable.

There are 300 million clinical cases of, and 1 million deaths from, malaria recorded per year.

Some 50 to 100 million people in Asia consume water containing unsafe levels of arsenic.

Providing sanitation in some places is made difficult by tradition and culture the stigma and embarrassment associated with talking and teaching about sanitation.

Climate change

Climate change is expected to bring more frequent and intense rain to many places, leading to floods and shallow sub surface water flow which can mobilize pathogens and other contaminants.

Higher temperature could change the rates of reproduction, survival and infectivity of various pathogens.

Flooding can also impact chemical storage and sewage facilities, compromising water supply quality. And drinking and wastewater infrastructure systems will be overwhelmed more often.

Sea-level rise will affect groundwater aquifers in coastal areas and flood low-lying areas, reducing freshwater availability.

By 2030 it is estimated that the risk of diarrhoea will be up to 10% higher in some countries due to climate change.

With the advent of climate change, pathogens may become endemic in altered ecologies. Even if not directly linked to health, these threats can have a devastating effect on the ecosystem, indirectly threatening water supplies.

Due to greater migration, diseases will be transported to other regions where they may or may not be able to survive, potentially exposing host communities to new diseases.


Contact: Terry Collins
United Nations University

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