Water and sanitation report card: slow progress, inadequate funding

WaterAid Policy Analyst Tim Brewer looks at the sobering picture of water and sanitation services provided by the World Health Organization’s report the Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS), produced by UN Water.


24 Nov 2014

Gabriel de Silva on the half kilometer hike that he has to make twice daily to procure the water that he and his wife Adalina require for cooking, drinking and washing, Camalelara, East Timor.
Gabriel de Silva on the half kilometre hike that he has to make twice daily to collect the water that he and his wife Adalina need for cooking, drinking and washing, East Timor. Credit: Dean Sewell/oculi/Agence Vu for WaterAid.

The Ebola crisis has thrown into sharp relief the issue of water, sanitation and hygiene (WASH) in treating and caring for the sick. Dying patients are being taken to hospitals which never had enough water to maintain hygiene, and the epidemic has pushed the system to breaking point.

Last week’s World Health Organization report, the Global Analysis and Assessment of Sanitation and Drinking Water (GLAAS), produced by UN Water, has provided a sobering picture of water and sanitation services so necessary to health-care systems around the world.

Half of the lucky minority of rural poor people who have gained access to improved water and sanitation are still using unregulated services which have no way to guarantee safety.

The annual analysis is a goldmine of data, covering 94 countries and using information from 23 aid agencies. The story it tells in 2014 is of modest progress alongside inadequate funding, poor monitoring and a desperate need for skilled regulators, administrators and engineers to keep services running effectively.

Poor targeting

Among GLAAS’s most important findings is how poorly finances intended to address the water and sanitation crisis are targeted. Urban areas are prioritised over rural, regardless of the level of need – nearly three quarters of aid spending goes to urban areas and more than 60% of aid is in the form of loans, which are rarely targeted to poor people. This suggests that rural people and urban poor people are being further marginalised.

Nearly three quarters of the aid targeted at WASH programmes is spent on drinking water supplies. Despite these investments in improved supplies, 1.8 billion people drink water contaminated with faecal matter.

Tackling inadequate sanitation

It’s fair to assume that this figure is linked to 2.5 billion people still being without a basic toilet. Too much money is being invested in finding or making clean water, and not enough in containing the waste that contaminates it.

Addressing these issues effectively requires money, training and monitoring, but these, too, are falling short.

The GLAAS report has found that financing for water and sanitation in 70% of responding countries covers less than 80% of the costs of operation and maintenance for existing services.

Regulators, administrators and engineers are all in short supply in developing countries. All are of critical importance in the safe, sustainable delivery of water and basic sanitation services, fundamental to good public health and economic growth. Yet it’s rare to see plans or investment to address this. Only one third of countries even have a human resources strategy in place.

Monitoring and reporting

Monitoring is also seriously poor. WaterAid is examining the sanitation transformations that took place in East Asia, and has found that responsive monitoring that actually leads to changes in policy and investment is a crucial driver of sanitation improvements. But very few countries have enough personnel to collect or review data, or enough senior political interest to demand it.

Fewer than half of countries have a formal rural service provider that reports to a regulatory authority and effectively monitors its services.

What does this mean? It means that half of the lucky minority of rural poor people who have gained access to improved water and sanitation are still using unregulated services which have no way to guarantee safety.

New goals provide hope

But there is progress. Proposals for the UN’s new Sustainable Development Goals (SDGs), now under negotiation, include goals for water and sanitation services that include schools and health-care facilities, along with households. This is of huge importance, particularly in view of the Ebola crisis in West Africa, where health-care systems were broken in years of conflict and never properly rebuilt, or the 2014 cholera outbreak in Ghana, where 20,900 people were infected and 166 died of infection transmitted by water contaminated with human waste.

The GLAAS reports that less than a third of countries have a plan for drinking water or sanitation in health-care facilities and schools that is implemented, funded and reviewed regularly. These targets are long overdue.

Sustainable responses to a worldwide problem

The state of water and sanitation is a global health crisis. Some 10 million children have died since 2000 of diarrhoeal illnesses directly linked to growing up without clean water, basic toilets and hygiene. It is possible to reach everyone, everywhere with WASH education, but it will require strong political will, a comprehensive and accelerated approach, and financing.

As the UN negotiates the new SDGs, the inclusion of a strong, dedicated goal on water and sanitation that incorporates water and sanitation targets into goals on health care will address many of these shortfalls.

What the present shortlist does not include, but which the GLAAS report has clearly shown, is the need to find and train people to drive this transformation, and keep services running sustainably.

Tim Brewer is WaterAid's Policy Analyst and coordinates our activities on monitoring and accountability. He tweets at @timbrewer1 and you can read more of his work here

This post orginally appeared on Inter Press Service >