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Governments Urged to Improve Access to Water, Sanitation

Why Sanitation and hygiene matter?

Bullet squareThey are the first line of defense against faecal-oral diseases.
Bullet squareDiarrhea causes two million deaths per year
Bullet squareOver 90 percent of the health effects are experienced by children under five.
Bullet squareThis is equivalent to one child dying every fifteen seconds.
Bullet squareDiarrhea accounts for about a third of total child deaths under the age of five in developing countries.

New York, May 9, 2005 - Governments have the primary role in promoting improved access to safe drinking water, basic sanitation and adequate shelter, concludes the Commission of Sustainable Development in the final statement of its 13th session at the United Nations.

The UN commission, which met last April 28, also encourages governments to improve governance at all levels and enable appropriate environments and regulatory frameworks with the active involvement of all stakeholders.


“Water security is achieved when water underpins economic growth, rather than undermining it – or, in other words, when the net impact of water on growth is positive. The tipping point in achieving water security will be the acquisition of a ‘minimum platform’ of management capacity and infrastructure investment,” notes a recent World Bank report on Water Security, Growth and Development.” 


Ian Johnson, Vice President for Sustainable Development at the World Bank, says that Below the minimum platform, water obstructs growth overall, above the minimum platform water enhances growth overall.” 


Until the 'minimum platform' is achieved, Johnson explains, the scale of social impacts (e.g. morbidity, mortality, resource conflict) and related economic impacts (e.g. from institutional failure, production inefficiencies, disaster shocks) can be such that the social fabric is significantly affected and economic growth cannot be reliably and predictably managed.


Thus investments in water are critical, the World Bank report insists. At all times, investments must be made both in infrastructure and institutions. In the poorest countries, where stocks of hydraulic infrastructure are low, investment in infrastructure will be a relative priority. Investment in management capacity and institutions becomes increasingly important as larger and more sophisticated infrastructure is built.


Interview with Jamal Saghir, Director Water & Energy, World Bank

video Video(Real)  Clip 1 | Clip 2

More than pipes


Increasing access to water supply and sanitation is more then just installing pipes, pumps, and toilets,” says Kathy Sierra, Vice President for Infrastructure at the World Bank. “Poor quality and unsustainable service are serious problems in many countries.”


For instance, Sierra explains, in rural Africa an estimated 20-50 percent  of existing water supply and sanitation facilities are operating poorly   if at all.   Improved governance is key for the achievement of water security and, as water and sanitation services are often decentralized, the many challenges lay at the local level.


Sanitation is key


The UN commission also highlights the need for urgent action to increase sanitation. If current trends continue the developing world is not going to be able to achieve in 2015 the United Nations target of reducing by 50 percent the number of people without access to basic sanitation.


According to United Nations figures, approximately 2.6 billion people, or 40 percent of the world's population, lack access to basic sanitation.  World Bank figures show that meeting the sanitation targets would require tripling annual investments from US$4 to US$12 billion a year, this number excludes much larger investments required to treat wastewater and safely dispose of it.


However, the challenge is not only in providing toilets and other hardware, but also in providing hygiene promotion to change peoples’ behavior.   For instance, globally, hands are washed with soap on less than 20 percent of the occasions when they should be. Evidence suggests that improved hand washing with soap at the right times can halve diarrhoeal infection.


“Sanitation can no longer be forgotten,” said Jamal Saghir, Director Water & Energy, World Bank. “The Millennium Development Goals for sanitation can only be met if politicians make bold decisions to create large-scale change.  The UN commission is a good start to boost the sanitation business.” 


“The major challenge facing the development community is one of implementation. Donors can play a major role through supporting hygiene promotion. This only requires small budgets and leverages household investments. We find that people are willing to pay for sanitation – and that simple technologies do not need to be expensive,” Saghir explains.


Hand washing


The World Bank is one of the largest donors for water supply and sanitation. After a decrease in the late 1990s, lending has tripled over the past three years. On average, over the last decade the Bank has provided loans for about US$1 billion dollars a year for water supply and sanitation work.


To increase access to sanitation, the World Bank supports a range of technical options to design the best product possible at a price that poor households can afford starting with on-site solutions which can be followed by sewerage and wastewater treatment.


Recognizing the need for improved at-scale hygiene promotion, The World Bank and partners have come together to work with governments to raise awareness, enhance political commitment and assist with fundraising, through coordinated country programs. 


The recently launched “Handwashing Handbook” shows how state-of-the art marketing techniques can be used to change people’s behavior. The Handbook is based on over three years of successful large scale programs in Ghana, Madagascar, Nepal, Peru, and Senegal.    It uses social marketing techniques to promote sanitation and hygiene through the media. From marketing to mothers through radio spots highlighting nurture to TV-spots aimed at teenagers showing that hygienic behavior is “cool” or through songs in schools to reach younger children, the approach has proved to be a huge success.


For the Hand washing Handbook and for more information on World Bank support to water supply and sanitation – go to


Special Media Background Paper on “Water Security, Growth and Development,” go to or



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