The Great Stench

Credit: WaterAid / Brent Stirton

Poor sanitation and water kill millions every year. So why, asks Larry Elliott, The Guardian's Economics Editor, are they such neglected areas in development?

They called it the Great Stench, and for the fight against infectious disease in Britain it was a turning point. It was the summer of 1858 and as temperatures rose, the sewage in the Thames became so vile that MPs had to stop work. Until then, the Mother of Parliaments had turned a blind eye to the deaths from infectious disease in fast-growing industrial towns. But once the Great Stench started to waft through the corridors of Westminster, MPs were forced to act.

A century and a half later, clean water and sanitation are taken for granted in the west. The same is not true, however, in the developing world, where 1.8 million children die every year from diarrhoea. Unclean water and poor sanitation are the second biggest killers of children, which is hardly surprising given that one billon people lack even minimal access to running water and 2.6 billion do not have access to basic sanitation.

Africa still has a Great Stench, and so does Asia. Not that you would know it from the reaction of the developed world, where the response is similar to that of parliament before 1858: hold your nose and pretend it's not happening.

Four years ago, the G8 met in Evian, home to the bottled mineral water. The host, then French President Jacques Chirac, announced a water initiative and persuaded the rest of the gang to sign up to an action plan backed with the promise of cash. As is often the way the agreement was not worth the paper it was written on. There has been no plan, no money and barely a whimper from those that should be holding the G8 to account.

Nor is water as important for Britain. Gordon Brown has been a champion of development, yet water, despite the urgings of the former International Development Secretary, Hilary Benn, is not one of the Government's aid priorities. The UK spends a little under £100m a year on aid for sanitation and water, the same financial commitment to 2.6 billion people as Jose Mourinho pays to bring a couple of strikers and a midfielder to Chelsea.

This lack of commitment, even with a planned doubling  of spending to £200m, is baffling. There is little point in his investing £15bn in education in developing countries over the next decade if a third of the children are unable to attend school because of diarrhoea, or in the case of many girls, have to walk several miles a day to collect water for the rest of the family.

Nor can it be said that there is a lack of hard evidence to support a properly resourced action plan for water and sanitation. In Britain's case, the historical data tells its own story. Child mortality in the UK did not really start to fall until the end of the 19th century, when the mid-Victorian improvements to water supply were matched by huge outlays on sanitation. In the late 1890s, infant mortality was 160 per 1000 live births - similar to the situation in Nigeria today - but this fell to 100 in little more than a decade, one of the sharpest declines on record.

It was an expensive business to build the sewers and lay the pipes in late 19thcentury Britain, just as it would be costly for developing countries to invest in clean water and sanitation today. But on any basis it would be a cracking investment. It is estimated that Africa loses about 5% of GDP through water-related illnesses.

Every $1 invested in water and sanitation generates about $6 in economic returns, even apart from the lives it saves.

Yet progress has been almost criminally slow since the UN made water and sanitation one of its millennium development goals. The UN devoted its human development report last year to water in the hope that it would prompt action from the international community. The report is an impressive document - it should and could be used by the G8 as a blueprint for action.

Yet, on current trends the target of halving the proportion of people without access to clean water and sanitation will be missed by huge margins, particularly in Africa but in Asia too.

What explains this inertia? The international community has acted on debt; money has been promised for schools, hospitals and immunisation. Water and sanitation are well down the list of priorities, in part because politicians in the west find it hard to imagine there are still people without flushing toilets and power showers and in part because the issue is a crisis of the poor in general and of women in particular, two constituencies with limited bargaining power.

The UN estimates that achieving the Millennium Development Goal on water and sanitation would cost about $10bn a year. The G8 must make good on the promises of Evian and come up with a global fund to mirror that for HIV/AIDS. Brown says - and he's right - that the greater the pressure from civil society the easier it is for progressive politicians to egg on their more cautious colleagues. It's time for the development community to take Brown at his word and start raising a big stink about the Great Stench.

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