The article is the fifth in a series of papers summarising the key conclusions of the Millennium Project - a three-year independent advisory effort commissioned by UN Secretary-General Kofi Annan to review progress of the Millennium Development Goals (MDG). The MDG's commit the international community to address extreme poverty, with quantitative targets set for the year 2015.
Jamie Bartram (World Health Organisation) and colleagues write that poor sanitation and a lack of safe drinking water is a 'silent humanitarian crisis' that kills some 3900 children everyday and thwarts progress to the MDG's, especially in Africa and Asia. While sufficient progress has been made to reach the overall target of halving the proportion of the population without access to safe drinking water between 1990 and 2015, meeting this target will still leave hundreds of millions of people without safe drinking water, particularly in east Asia and sub-Saharan Africa. The article calls for immediate concerted efforts to confront the reality that sanitation coverage rates in the developing world barely keep pace with population growth. Four out of ten people in the world do not have access to a simple pit latrine.
The authors state that although access to safe drinking water and basic sanitation can have a strong positive effect on human health, the development and management of water resources as a whole has significant health implications. Man-made reservoirs and irrigation schemes help provide food and nutrition but they can also form ideal habitats for intensified transmission of schistosomiasis, an infection caused by a type of flatworm. Irrigation infrastructure and management of irrigation can be designed to keep transmission to a minimum. Improving irrigation to avoid standing or slow-moving water and improving disposal of household wastewater can also reduce mosquito breeding and transmission of malaria.
The paper recommends dramatic scaling up of efforts, involving the expansion of safe drinking water and sanitation coverage, in order to meet the MDG water and sanitation target by 2015. The authors write that this requires neither colossal sums of money nor scientific breakthroughs or technological advances.
Dr Bartram concludes: "Investment in water is an efficient and effective way to combat waterborne and vector-borne diseases. In view of the financial constraints and shortages of trained health professionals in the poorest countries of the world, it is a priority that the international health community needs to give the attention it deserves."
Contact: Dr Jamie Bartram, Coordinator, Water, Sanitation and Health Programme, World Health Organization, 20 Avenue Appia, CH-1211, Geneva 27, Switzerland. T) 41-22-791-3537 or 41-22-791-3589 bartramj@who.int
Journal
The Lancet