by Liz Borkowski 

Nearly half of Mumbai’s 18 million residents live in unofficial settlements called zopadpatti. In one of these areas, Dharavi, estimates suggest there is one toilet for every 1,4440 people, tap water flows for only two hours each day, and approximately 15 families share each water tap.

Around the globe, rural residents are migrating to urban areas and expanding these unofficial settlements, where global challenges in water and sanitation are highly visible. Many rural areas that struggled with water to begin with face new constraints as aquifers are depleted and global warming shrinks once-reliable water sources.

The 2015 Millennium Development Goals deadline is approaching quickly, and we’re unlikely to meet the MDG targets if we don’t address the crisis in water and sanitation. That’s according to a new report from the UNDP, which warns that one in five people living in the developing world lacks access to clean water and that 2.6 billion people – nearly half of the total developing-country population – lack access to adequate sanitation.

MDG #7, “Ensure environmental sustainability,” includes a target of halving the proportion of people without sustainable access to safe drinking water. In addition, water and sanitation are important for the goals of reducing poverty and child mortality and achieving universal primary education and gender equality. The report includes some illustrative numbers:

• Diarrhea, associated with unclean water and lack of sanitation, claims the lives of 1.8 million children under the age of 5. Globally, diarrhea kills more people than tuberculosis or malaria.
• Water-related diseases cost 443 million school days each year, and children in poor health suffer from reduced cognitive potential. This hurts their prospects for future earnings and makes continuing poverty more likely.
• The burden of disease linked to water and sanitation accounts for 60 million disability-adjusted life years lost annually, according to the WHO.
• In Mozambique, rural Senegal, and eastern Uganda, women spend an average of 15 -17 hours collecting water every week – which means less time for education, income generation, and leisure. In Tanzania, girls whose homes are 15 minutes or less from a water source have 12% higher levels of school attendance.
• By one estimate, half of the girls who drop out of school in Sub-Saharan Africa do so because of poor water and sanitation facilities.

As one might expect, these burdens fall disproportionately on the poor. About two-thirds of the people without access to a protected water source (piped water or a protected well) live on less than $2 a day … and yet, these are the people who have to pay large sums for water. Water tankers and bottled-water sellers serve the areas that lack accessible clean water, and they charge far more than the utilities whose service is concentrated in wealthier urban areas. In Jakarta, Lima, Manila, and Nairobi, households in slums and low-income settlements typically spend 5 to 10 times more for their water than their high-income neighbors.

What’s Needed
With improved water and sanitation, infant mortality and the overall disease burden will drop; women and girls will have more time for education, leisure, and income generation; and households will be able to devote more of their income to health, education, nutrition, and production. In fact, the WHO estimates that each $1 invested in water and sanitation in low-income countries will yield an average return of $8 in saved time, increased productivity, and reduced health costs.

As a baseline, the WHO and UNICEF suggest a minimum requirement of 20 liters of water a day from a source within one kilometer of the household. This can take care of drinking and basic personal hygiene; bathing and laundry needs increase the requirement to around 50 liters daily. (In European countries, average use is 200- 300 liters per person per day; in the US, it’s 575.)

Although it doesn’t lend itself so well to photo ops, sanitation is just as important as water, and the two are mutually reinforcing. It’s harder to supply a population with clean water when the waterways are full of human waste.

Many countries exhibit a “water-sanitation gap,” with sanitation improvements failing to keep pace with increased water access. The MDG sanitation target is to halve the proportion of people without improved sanitation. As it stands now, 55 countries are off track for reaching the MDG target, while 74 countries are off track for reaching the sanitation target.

Getting the world on track to meet the water and sanitation MDGs will require $10 billion a year for low-cost, sustainable technology. To put that in context, the report authors note that this figure represents about eight days of global military spending.

Turning on the Funding Tap
We can probably all agree that this would be a $10 billion worth spending, but water and sanitation projects require lots of up-front investment that won’t show returns immediately. UNDP has some suggestions.

Governments of the countries where water and sanitation are currently inadequate are typically spending less than 0.5% of GDP on these areas, and they should be spending 1%. National budgets should include real long-term commitments. Pro-poor policies should ensure that poor households receive free water up to a specified minimum and that cost-recovery measures are equitable. (The report sets aside the debate on water privatization, but it suggests that private suppliers would need to be subject to rules for making water affordable to the poor.)

In many countries—particularly in Sub-Saharan Africa—the combination of 1% GDP government contributions and equitable user fees (set so households don’t spend more than 3% of income on water) still won’t be enough. International aid must fill the gap, and that means it has to increase – immediately, and by about $4 billion a year in order to bring the MDG targets within reach. In addition, donors can countries reduce risks and borrowing costs through measures such as credit guarantees.

It’s still possible to meet the MDG water and sanitation targets, but time is running short. This isn’t just the right choice economically; it’s also a moral imperative.

Liz Borkowski is a research associate with the Project on Scientific Knowledge and Public Policy (SKAPP).