, and Links to Health FACTS AND FIGURES - *updated March 2004

"Water and Sanitation is one of the primary drivers of . I often refer to it as “Health 101”, which means that once we can secure access to clean water and to adequate sanitation facilities for all people, irrespective of the difference in their living conditions, a huge battle against all kinds of will be won." Dr LEE Jong-wook, Director-General, World Health Organization.

Diarrhoea - 1.8 million people die every year from diarrhoeal Intestinal helminths (, , diseases (including ); 90% are children under 5, Hookworm ) mostly in developing countries. - 133 million people suffer from high intensity - 88% of diarrhoeal disease is attributed to unsafe intestinal helminth infections, which often leads to , inadequate sanitation and hygiene. severe consequences such as cognitive impairment, - Improved water supply reduces diarrhoea morbidity massive , or anaemia. by 21%. - These diseases cause around 9400 deaths every year. - reduces diarrhoea morbidity by - Access to safe water and sanitation facilities and 37.5%. better hygiene practice can reduce morbidity from - The simple act of washing hands at critical times can ascariasis by 29% and hookworm by 4%. reduce the number of diarrhoeal cases by up to 35%. - Additional improvement of drinking-, Japanese encephalitis such as point of use disinfection, would lead to a - 20% of clinical cases of Japanese encephalitis die, reduction of diarrhoea episodes of 45%. and 35% suffer permanent brain damage. - Improved management for of water Malaria reduces of disease, in South, - 1.2 million people die of malaria each year, 90% of South East, and East Asia. whom are children under 5. - There are 396 million episodes of malaria every year, A most of the is in Africa south of the - There are 1.5 million cases of clinical Sahara. every year. - Intensified irrigation, dams and other water related projects contribute importantly to this disease burden. Arsenic - Better management of reduces - In Bangladesh, between 28 and 35 million people transmission of malaria and other vector-borne consume drinking-water with elevated levels of arsenic diseases. in their drinking-water. - The number of cases of skin lesions related to arsenic in drinking-water in Bangladesh is estimated at 1.5 - An estimated 160 million people are infected with million. schistosomiasis. - Arsenic contamination of ground water has been - The disease causes tens of thousands of deaths every found in many countries, including Argentina, year, mainly in sub-Saharan Africa. Bangladesh, Chile, China, India, Mexico, and - It is strongly related to unsanitary excreta disposal the . and absence of nearby sources of safe water. - The key to prevention is reducing consumption in - Basic sanitation reduces the disease by up to 77%. drinking-water with elevated levels of arsenic, by - Man-made reservoirs and poorly designed irrigation identifying alternative low arsenic water sources or by schemes are main drivers of schistosomiasis expansion using arsenic removal systems. and intensification. Fluorosis - Over 26 million people in China suffer from dental - 500 million people are at risk from trachoma. fluorosis due to elevated fluoride in their drinking - 146 million are threatened by blindness. water. - 6 million people are visually impaired by trachoma. - In China, over 1 million cases of skeletal fluorosis are - The disease is strongly related to lack of face thought to be attributable to drinking-water. washing, often due to absence of nearby sources of safe - The principal mitigation strategies include water. exploitation of deep-seated water, use of water, - Improving access to safe water sources and better reservoir construction and defluoridation. hygiene practices can reduce trachoma morbidity by 27%.

DRIVING FORCES THE GLOBAL RESPONSE

Access to water supply and sanitation Millennium Development Goals (MDGs) - In 2000, 2.4 billion people lacked access to By including water supply, sanitation and hygiene improved sanitation. 81% of these were in rural in the MDGs, the world community has areas. acknowledged the importance of their promotion as - In 2000, 1.1 billion people lacked access to development interventions and has set a series of improved water sources. 86% of these were in rural goals and targets. areas. - Coverage for both improved water supply and Goal 7: Ensure environmental sanitation lags behind in the poorest communities - • Target 9: Integrate the principles of sustainable in rural areas and in urban/peri-urban . development into country policies and program and reverse the loss of environmental resources. The sanitation gap • Target 10: - Only 53% of the sub-Saharan population is served - Halve by 2015, the proportion of people with sanitation services. without sustainable access to safe drinking - In South Central Asia only 38% of the population water and basic sanitation. is served with sanitation services. - Integrate sanitation into water resources - Access to sanitation in rural areas is much worse management strategies. than in urban areas. - Target 11: Have achieved by 2020, a - 930 million people live in slums and most significant improvement in the of at population growth is expected to occur in urban least 100 million dwellers. areas. Goal 4: Reduce • Target 5: Reduce by two-thirds, between 1990 and Emergencies and disasters 2015, the under-five mortality rate. - Almost two billion people were affected by Goal 6: Combat HIV/AIDS, malaria, and other natural disasters in the last decade of the 20th diseases century, 86% of them by and . • Target 8: Have halted by 2015 and begun to - Flooding increases the ever-present health threat reverse the incidence of malaria and other major from contamination of drinking-water systems from diseases. inadequate sanitation, with and by refuse dumps. Water for Decade: 2005-2015 - Droughts cause the most ill-health and death - UN Declares 2005-2015 "Water for Life" as the because they often trigger and exacerbate International Decade for Action and famine, and deny access to and set's the world agenda on a greater focus on adequate water supplies. water-related issues. - Disaster management requires a continuous chain of activities that includes prevention, preparedness, Salient quotes emergency response, relief and recovery. “We shall not finally defeat AIDS, tuberculosis, Water resources development malaria, or any of the other infectious diseases that - The development of water resources continues in plague the developing world until we have also an accelerated pace to meet the fibre and won the battle for safe , sanitation needs of a of 8 billion by and basic .” Kofi Annan, 2025. Secretary-General - Lack of capacity for transfers hidden costs to the health sector and “The human right to water entitles everyone to increases the disease burden on local communities. sufficient, safe, acceptable, physically accessible - Environmental management approaches for health and affordable water for personal and domestic need to be incorporated into strategies for uses” – General Comment No. 15 (2002): The integrated water resources management. Right to Water.

*All figures are best available estimates as of March 2004

World Health Organization 2004