http://www.healthsentinel.com/Briefs/WaterAndSanitation.htm

WEHAB Working Group, "A Framework for Action on Water and Sanitation", World Summit on Sustainable Development - Johannsesburg 2002 - United Nations, August 1, 2002, Num. 0,

“Water is essential for life. It is the key resource for people's good health, for irrigating crops, for providing hydropower, for protecting ecosystems. Despite the broad recognition of the central role of water in sustainable development, including in efforts to eradicate poverty, addressing the water needs of the poor through concerted global action has not been given enough priority. While progress has been made over the decade since the Rio Earth Summit, on average it has been slower than anticipated.”

“Water resources in many countries remain fragile, more due to poor demand-and-supply management than to actual water scarcity. Measures promoting sustainable use of water are far from satisfactory. About 1.2 billion people still have no access to safe drinking water, and 2.4 billion do not have adequate sanitation services. Some 2 million children die every year from water-related diseases. In the poorest countries, one in five children dies before the age of five mainly from water-related infectious diseases arising from insufficient water availability, in both quantity and quality. Thus provision of safe drinking water and sanitation services to more than 1 billion people over the next decade remains one of the most critical challenges humanity is facing today.”

“In addition to freshwater systems, estuarine, near-shore and oceanic systems provide renewable food supplies, tourism opportunities, transportation highways, biotechnology supermarkets and many more benefits that are frequently overlooked or abused in many parts of the world. Waterways direct pollutants and solid waste to the coastal zone, where they accumulate along the coastal fringe, the home of nearly half of the world's population and a concentration of the most productive, biologically diverse ecosystems. Municipal wastewater emissions are one of the most significant threats to sustainable coastal development world-wide. Their effects are usually localized, but they are a major source of coastal and marine contamination in all regions and therefore a global issue.”

“Pollution of water resources is on the increase in many places, and water distribution and use efficiencies are low both in irrigation and in urban water supply networks. Water tables are dropping, many rivers no longer reach the sea, freshwater aquatic species are in peril and deltas and wetlands are disappearing. Water is more and more a resource in dispute, and conflicts over its use and distribution are common. By 2025, urban populations in developing countries will have doubled over today's figures, to 4 billion. Unfortunately, sanitation and water programmes globally are not geared to keep pace with these shifting and growing populations and are saddled with a traditional top-down approach with almost no participation of those needing services. In addition, not only are systems poorly designed and underfinanced, but regulatory and management aspects remain extremely weak. There is little match between resources available and the choice and design of systems.”

“Access to water is already a major limiting factor in the socioeconomic development of many countries. There is growing concern regarding the increasing stress on water resources caused by population growth, unsustainable consumption patterns and uncontrolled uses. High distribution losses put further stress on available supplies. Data on water use worldwide provide a stark example of the wide gulf between the rich and the poor worlds: people in developing countries use about 20 litres of water a day, and even less in some places, while those in the industrial world use 400-500 litres.”

•  Four out of every 10 people currently live in river basins experiencing water scarcity. By 2025, at least 3.5 billion people, nearly 50 per cent of the world, will face water scarcity.
• Some 6,000 children die every day from diseases associated with lack of access to safe drinking water, inadequate sanitation and poor hygiene.
• At any one time, half of the world's hospital beds are occupied by patients suffering from waterborne diseases.
•  In China, India and Indonesia, twice as many people are dying from diarrhoeal diseases as from HIV/AIDS.
• Overpumping of groundwater by the world's farmers exceeds natural recharge rates by at least 160 billon cubic metres a year.
• Nearly 30 per cent of the world's major watersheds have lost more than three-quarters of their original forest cover.
• Water losses in irrigated agriculture amount to 25-40 per cent of water used in agriculture."
  
  
  “In countries seriously affected by drought, land degradation, desertification or floods-all of which are on the increase due to climate change and variability and also human activities-the poor are the most vulnerable and frequently the first victims, since they rely essentially on land and water resources to sustain their livelihoods. The productivity of water in agriculture remains low, hampering efforts at income generation, economic growth and sustainable development. The presence of toxic elements in water-fluoride in India and China, for example, and arsenic in groundwater in Bangladesh-has led to serious public health risks.”
  
  “Over the last two decades, the number and scale of water-related disasters has increased greatly because of climate change and variability as well as increasing demand due to indiscriminate growth without proper supply management. Projected climate changes during this century will exacerbate the North-South divide by worsening poverty in developing countries. Among the changes these nations will need to adapt to are an increase in the frequency and intensity of severe weather causing droughts, floods, higher temperatures and rising sea levels. These will greatly increase the vulnerability of the poorest to natural disasters, imperil food and water scarcity, adversely affect human health, speed ecosystem destruction and jeopardize livelihoods.”
  
  “Financial resources remain the most limiting constraint. Water and sanitation infrastructure projects are usually capital-intensive. For many developing countries, the flow of financial assistance from rich countries and multilateral institutions has been much lower than warranted by the magnitude of the crisis. The debt situation continues to discourage investments in infrastructure. At the same time, domestic resource mobilization efforts (such as efficient tariff systems, recovery of bills and taxes and a systematic reduction of subsidies) have not been sufficiently promoted. Neither have countries seriously pursued the use of debt-swap mechanisms that would have generated local currency to finance local costs. Lack of political will to invest in improving the services, and to extend those services to poor communities, also inhibited the flow of concessional resources. And too little has gone into developing appropriate frameworks that could contribute by sustaining the impacts of investment in infrastructure development.”
  
  “Poor water quality continues to pose a major threat to human health. Although faecal contamination in water is still the pollutant that most seriously affects the health of children, the increasing seriousness of other contaminants has become evident in recent years. Arsenic, fluoride and nitrates top the list of emerging threats to the quality of water for domestic consumption. Diarrhoea, cholera, typhoid and schistosomiasis are the leading water-borne diseases. Some 200 million people world-wide have schistosomiasis, of whom 20 million suffer severe consequences. Diarrhoeal diseases, a result of lack of adequate water and sanitation services, in the past 10 years have killed more children than all people lost to armed conflict since World War II. Water quality is deteriorating in many places, and some cities in the developing world treat only about 10 per cent of their sewage. As a result, developing countries are facing enormous health crises.”
  
  “Studies show that improvements to sanitation and hygiene have the following impact:
  
  o Improved sanitation can reduce episodes of diarrhoea by up to 40 per cent, deaths by up to 60 per cent and child stunting by up to 50 per cent.
  
  o The simple act of washing hands at critical times (after using the toilet, after handling infant faeces and before handling or eating food) can reduce diarrhoeal episodes by up to 33 per cent.
  
  o Food hygiene can reduce diarrhoeal episodes by up to 70 per cent.
  
  o Convenient access to safe water alone can reduce episodes of diarrhoea by up to 15 per cent.
  
  When these components are fully integrated and strategically programmed with other key sectors such as health and education, the overall benefits and impact can be significant .”
  
  “There is a common misunderstanding that providing clean water to households will resolve all so-called water-related health concerns. But people's health will not improve simply because toilets are built unless this is accompanied by improvements in hygiene behaviour. Although the International Drinking Water Supply & Sanitation Decade of the 1980s spurred improvements in access to safe water for over 3.4 billion people in developing countries, these efforts have not been matched in sanitation and hygiene. Almost 2.4 billion people are still without appropriate sanitation facilities. Sanitation and hygiene programmes should focus on influencing key changes in behaviour through improved hygiene practices.”
  
  “While liquid waste sewage systems have been widely successful in controlling the transmission of excreta-related diseases in the cities of industrial countries, they also created severe damage to ecosystems and water resources where wastewater was inadequately treated. Pathogenic organisms, for example, in domestic wastewater-contaminated marine and estuarine waters cause massive transmissions of infectious diseases to bathers and consumers of raw and undercooked shellfish-with the global economic impact recently estimated at US$10 billion a year. Since proper treatment considerably increases the cost and energy requirements of the entire system without being essential for the day-to-day life of the user, it is often omitted-especially when financial resources are scarce. Research and development needs to focus on alternative, affordable, non-polluting sanitation systems.”
  
  “Hygiene improvement results from the sustained practice of safe hygiene behaviours, improved awareness and skills for maintenance of household water security and support for healthier environments in which people live. This can only be achieved through a combination of convenient access to sanitary toilet facilities and to sufficient quantities of safe water for drinking and for personal and domestic hygiene. Hygiene improvement is a critical factor in combating the diarrhoeal diseases and intestinal-worm infestations that cause sickness and death among children.”
  
  “Inappropriate use of fertilizers and pesticides and animal pollution (nitrates) often results in severe pollution of surface and groundwater.”
  
  “The capacity of freshwater ecosystems to support biodiversity is highly degraded at the global level, with many freshwater species facing rapid population declines or extinction. Half the world's wetlands have been lost in the past century. The continued neglect of the minimum water requirements or maintaining healthy aquatic ecosystems in terms of both quantity and quality has devastating consequences on natural capital, aquatic biodiversity and human health. Pollution impacts on coastal areas have been far-reaching, triggering algal blooms, damaging reefs, destroying habits and hurting fisheries. Insufficient progress has occurred on this front since Rio. The situation is gradually worsening because of growing conflicts between biodiversity conservation and increasing demands for land and water for other purposes.”
  
  Authors Note:
  This is a mammoth human tragedy and an outrage. The equivalent of two world trade center/9-11 terrorist assaults occurs daily to children in the world from a lack of clean drinking water and sanitation. This is a crime that is hardly mentioned by western governments, the press, or very many people at all. While the creation of systems to supply fresh water and eliminate waste, and the hygiene revolution essentially eliminated all diseases that plagued western societies in the 1800s and early 1900s, this increased stress on clean water and sanitation systems, western societies could also find themselves reliving a part of history most would not welcome. We need to pay attention to this major health problem that plagues the world or suffer the consequences of our inaction.